A Multicenter Evaluation of the Seraph 100 Microbind Affinity Blood Filter for the Treatment of Severe COVID-19.

Autor:	Chitty SA; Southeast Georgia Health System, Brunswick, GA., Mobbs S; Southeast Georgia Health System, Brunswick, GA., Rifkin BS; Hattiesburg Clinic, Hattiesburg, MS., Stogner SW; Hattiesburg Clinic, Hattiesburg, MS., Lewis MS; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA., Betancourt J; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA., DellaVolpe J; Methodist Hospital, San Antonio, TX., Abouzahr F; Methodist Hospital, San Antonio, TX., Wilhelm AM; University of Mississippi Medical Center, Jackson, MS., Szerlip HM; Baylor Scott & White Health, Dallas, TX., Parikh A; Advent Health, Orlando, FL., Gaeta RM; Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA., Rivera I; Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA., Park C; University of Texas Southwestern Medical Center, Dallas, TX., Levi B; University of Texas Southwestern Medical Center, Dallas, TX., Anesi GL; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA., Alcover KC; Department of Medicine, Uniformed Services University of the Heath Sciences, Bethesda, MD., Arnold TB; Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD.; The Metis Foundation, San Antonio, TX., Howard JT; University of Texas San Antonio, San Antonio, TX., Sharma K; Center of Renal Precision Medicine, Department of Medicine, University of Texas Health San Antonio, San Antonio, TX., Pratt KP; Department of Medicine, Uniformed Services University of the Heath Sciences, Bethesda, MD., Stewart IJ; Department of Medicine, Uniformed Services University of the Heath Sciences, Bethesda, MD., Chung KK; Department of Medicine, Uniformed Services University of the Heath Sciences, Bethesda, MD.
Jazyk:	angličtina
Zdroj:	Critical care explorations [Crit Care Explor] 2022 Mar 25; Vol. 4 (4), pp. e0662. Date of Electronic Publication: 2022 Mar 25 (Print Publication: 2022).
DOI:	10.1097/CCE.0000000000000662
Abstrakt:	The Seraph100 Microbind Affinity Blood Filter (Seraph 100) (ExThera Medical, Martinez, CA) is an extracorporeal therapy that can remove pathogens from blood, including severe acute respiratory syndrome coronavirus 2. The aim of this study was to evaluate safety and efficacy of Seraph 100 treatment for COVID-19. Design: Retrospective cohort study. Setting: Nine participating ICUs. Patients: COVID-19 patients treated with Seraph 100 ( n = 53) and control patients matched by study site ( n = 53). Intervention: Treatment with Seraph 100. Measurements and Main Results: At baseline, there were no differences between the groups in terms of sex, race/ethnicity, body mass index, and need for mechanical ventilation. However, patients in the Seraph 100 group were younger (median age, 54 yr; interquartile range [IQR], 41-65) compared with controls (median age, 64 yr; IQR, 56-69; p = 0.009). Charlson comorbidity index scores were lower in the Seraph 100 group (2; IQR, 0-3) compared with the control group (3; IQR, 2-4; p = 0.006). Acute Physiology and Chronic Health Evaluation II scores were also lower in Seraph 100 subjects (12; IQR, 9-17) compared with controls (16; IQR, 12-21; p = 0.011). The Seraph 100 group had higher vasopressor-free days with an incidence rate ratio of 1.30 on univariate analysis. This difference was not significant after adjustment. Seraph 100-treated subjects were less likely to die compared with controls (32.1% vs 64.2%; p = 0.001), a difference that remained significant after adjustment. However, no difference in mortality was observed in a post hoc analysis utilizing an external control group. In the full cohort of 86 treated patients, there were 177 total treatments, in which only three serious adverse events were recorded. Conclusions: Although this study did not demonstrate consistently significant clinical benefit across all endpoints and comparisons, the findings suggest that broad spectrum, pathogen agnostic, blood purification can be safely deployed to meet new pathogen threats while awaiting targeted therapies and vaccines. Competing Interests: The authors have disclosed that they do not have any potential conflicts of interest. (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.)
Databáze:	MEDLINE
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