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 ORCID:

Zhifeng ZHOU

https://orcid.org/0000-0003-3160-589X

Ling ZHANG

https://orcid.org/0000-0003-1155-4802

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Journal of Zhejiang University SCIENCE B 2021 Vol.22 No.9 P.701-717

http://doi.org/10.1631/jzus.B2100344


Application of extracorporeal therapies in critically ill COVID-19 patients


Author(s):  Zhifeng ZHOU, Huang KUANG, Yuexian MA, Ling ZHANG

Affiliation(s):  Department of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China; more

Corresponding email(s):   zhouzf97@163.com, zhangling_crrt@163.com

Key Words:  Coronavirus disease 2019 (COVID-19), Critical illness, Cytokine release syndrome (CRS), Acute kidney injury (AKI), Extracorporeal therapy


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Zhifeng ZHOU, Huang KUANG, Yuexian MA, Ling ZHANG. Application of extracorporeal therapies in critically ill COVID-19 patients[J]. Journal of Zhejiang University Science B, 2021, 22(9): 701-717.

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Abstract: 
The coronavirus disease 2019 (COVID-19) pandemic is a major public health event caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 has spread widely all over the world. A high proportion of patients become severely or critically ill, and suffer high mortality due to respiratory failure and multiple organ dysfunction. Therefore, providing timely and effective treatment for critically ill patients is essential to reduce overall mortality. Convalescent plasma therapy and pharmacological treatments, such as aerosol inhalation of interferon-α (IFN-α), corticosteroids, and tocilizumab, have all been applied in clinical practice; however, their effects remain controversial. Recent studies have shown that extracorporeal therapies might have a potential role in treating critically ill COVID-19 patients. In this review, we examine the application of continuous renal replacement therapy (CRRT), therapeutic plasma exchange (TPE), hemoadsorption (HA), extracorporeal membrane oxygenation (ECMO), and extracorporeal carbon dioxide removal (ECCO2R) in critically ill COVID-19 patients to provide support for the further diagnosis and treatment of COVID-19.

体外疗法在重症COVID-19患者中的应用

概要:新型冠状病毒型肺炎(COVID-19)大流行是由严重急性呼吸系统综合症冠状病毒2(SARS-CoV-2)引起的重大公共卫生事件。COVID-19已在世界各地广泛传播。很大比例的患者因呼吸衰竭和多器官功能障碍而发展为重症或危重症,并且死亡率很高。因此,为危重患者提供及时有效的治疗对于降低总体死亡率至关重要。恢复期血浆治疗,干扰素-α(IFN-α)、皮质类固醇和托珠单抗的气雾吸入等药物治疗均已应用于临床治疗,但其效果仍存在争议。最近的研究表明,体外疗法可能在治疗COVID-19危重患者方面发挥潜在作用。在这篇综述中,我们阐述了连续性肾脏替代疗法(CRRT)、治疗性血浆置换(TPE)、血液吸附(HA)、体外膜肺氧合(ECMO)和体外二氧化碳清除(ECCO2R)在重症COVID-19患者中的应用,为COVID-19的进一步诊断和治疗提供支持。

关键词:新型冠状病毒型肺炎(COVID-19);重症疾病;细胞因子释放综合征(CRS);急性肾损伤(AKI);体外疗法

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