The Efficacy of Continuous Renal Replacement Therapy and Hemoabsorption Treatments in COVID-19 Patients in the Intensive Care Unit: A Retrospective Evaluation

Objective: The World Health Organization has emphasized that as there is no specific anti-coronavirus disease-2019 (COVID-19) treatment, supportive care according to disease severity is important. Previous studies have shown that acute kidney injury (AKI) develops in 30% of severe COVID-19 patients followed up in intensive care units and most these require renal replacement therapy. This study aimed to evaluate the COVID-19 prognosis, renal function, and organ systems of adult, severe COVID-19 patients treated with continuous renal replacement therapy (CRRT) and the effects on secondary hemophagocytic lymphohistiocytosis with the additional application of absorption filters. Materials and Methods: A retrospective examination was made of the data of COVID-19 patients who applied for CRRT between 11.03.2020 and 15.06.2021. The demographic data of the patients were recorded together with the renal function test results before and after CRRT, and the biochemical parameters were included in the COVID-19 prognosis. Results: Positive changes were determined in the kidney functions with CRRT applied to patients who developed AKI. No statistically significant difference was observed in the biochemical parameters included in the COVID-19 prognosis. In the 14 patients who applied with hemoabsorption, the need for short-term inotropic support was reduced. In our study, the mortality of the patients who were treated with CRRT was 95% (2 patients transferred to the ward), while the average intensive care unit stay was 18.2 +/- 11 days. While improvement was detected in renal function tests with CRRT applied to patients with AKI, no statistically significant difference was found in biochemical parameters in the prognosis of COVID-19. While mortality was 92.8% in 14 patients who underwent hemoabsorption, a short-term improvement was observed in the need for inotropes in these patients. Conclusion: Although vaccinations are expected to definitively eliminate COVID-19, for critical COVID-19 patients for whom the treatment options are limited, it would seem rational to adopt immunomodulator strategies including extracorporeal blood purification and supportive treatment such as CRRT. The results of this study have shown that CRRT applied to severe COVID-19 patients who develop AKI is an effective treatment for kidney failure. However, the effect on the progression of COVID-19 could not be clearly shown.