Critical risks of haemoadsorption for COVID-19 patients and directions for future evaluations: a nationwide propensity score matched cohort study
Abstract Haemoadsorption has been suggested as treatment adjunct for sepsis and septic shock, cardiac surgery, acute respiratory distress syndrome, and coronavirus disease 2019 (COVID-19). Randomised clinical trials did not provide conclusive evidence for benefits and even suggest risks in COVID-19...
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Nature Portfolio
2025-08-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-025-13860-0 |
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| author | Jan Andreas Kloka Thomas Jasny Oliver Old Elina Nürenberg-Goloub Christina Scharf Patrick Meybohm Alexander Supady Kai Zacharowski Benjamin Friedrichson |
| author_facet | Jan Andreas Kloka Thomas Jasny Oliver Old Elina Nürenberg-Goloub Christina Scharf Patrick Meybohm Alexander Supady Kai Zacharowski Benjamin Friedrichson |
| author_sort | Jan Andreas Kloka |
| collection | DOAJ |
| description | Abstract Haemoadsorption has been suggested as treatment adjunct for sepsis and septic shock, cardiac surgery, acute respiratory distress syndrome, and coronavirus disease 2019 (COVID-19). Randomised clinical trials did not provide conclusive evidence for benefits and even suggest risks in COVID-19 patients. Retrospective observational cohort study based on hospital remuneration data from all COVID-19 patients treated in intensive care units in Germany between 01/01/2020 and 12/31/2021. Regression modelling was performed for 1:1 propensity score matching of 2058 patients. Two-sided probability values for group comparisons and regression models with spline functions controlling for non-linear relationships and medically relevant interaction variables were calculated. In-hospital mortality of patients supported with haemoadsorption was significantly higher compared to matched control patients (74.6% vs. 70.3%, p = 0.0299). Haemoadsorption was associated with coagulopathy (68.0% vs. 54.9%, p < 0.0001), cardiac arrhythmia (49.2% vs. 44.2%, p = 0.0272), and cardiopulmonary resuscitation (CPR, 19.3% vs. 13.1%, p = 0.0002). Further, haemoadsorption increased the chance of death for COVID-19 patients without septic shock (odds ratio, OR [within a 95% confidence interval, CI]; 1.40 [1.05–1.86]) and did not improve survival of septic shock patients (1.19 [0.85–1.67]). Independent variables with a significant impact on mortality included the use of extracorporeal membrane oxygenation (ECMO, 2.15 [1.68–2.76]) and CPR (1.60 [1.03–2.45]). The timing of the haemoadsorption therapy had no effect on patients´ outcomes. Due to inconclusive evidence for benefit and potential harm, haemoadsorption therapy should be limited to thoroughly designed clinical trials before introduced into clinical routine in the context of COVID-19. |
| format | Article |
| id | doaj-art-137cd2c2215c4d7aa0f6088030b54d91 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-137cd2c2215c4d7aa0f6088030b54d912025-08-20T04:01:51ZengNature PortfolioScientific Reports2045-23222025-08-0115111210.1038/s41598-025-13860-0Critical risks of haemoadsorption for COVID-19 patients and directions for future evaluations: a nationwide propensity score matched cohort studyJan Andreas Kloka0Thomas Jasny1Oliver Old2Elina Nürenberg-Goloub3Christina Scharf4Patrick Meybohm5Alexander Supady6Kai Zacharowski7Benjamin Friedrichson8Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Goethe University, University Hospital FrankfurtDepartment of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Goethe University, University Hospital FrankfurtDepartment of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Goethe University, University Hospital FrankfurtDepartment of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Goethe University, University Hospital FrankfurtDepartment of Anaesthesiology, University Hospital, LMU MunichDepartment of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital WürzburgInterdisciplinary Medical Intensive Care, Faculty of Medicine, Medical Center - University of Freiburg, University of FreiburgDepartment of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Goethe University, University Hospital FrankfurtDepartment of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Goethe University, University Hospital FrankfurtAbstract Haemoadsorption has been suggested as treatment adjunct for sepsis and septic shock, cardiac surgery, acute respiratory distress syndrome, and coronavirus disease 2019 (COVID-19). Randomised clinical trials did not provide conclusive evidence for benefits and even suggest risks in COVID-19 patients. Retrospective observational cohort study based on hospital remuneration data from all COVID-19 patients treated in intensive care units in Germany between 01/01/2020 and 12/31/2021. Regression modelling was performed for 1:1 propensity score matching of 2058 patients. Two-sided probability values for group comparisons and regression models with spline functions controlling for non-linear relationships and medically relevant interaction variables were calculated. In-hospital mortality of patients supported with haemoadsorption was significantly higher compared to matched control patients (74.6% vs. 70.3%, p = 0.0299). Haemoadsorption was associated with coagulopathy (68.0% vs. 54.9%, p < 0.0001), cardiac arrhythmia (49.2% vs. 44.2%, p = 0.0272), and cardiopulmonary resuscitation (CPR, 19.3% vs. 13.1%, p = 0.0002). Further, haemoadsorption increased the chance of death for COVID-19 patients without septic shock (odds ratio, OR [within a 95% confidence interval, CI]; 1.40 [1.05–1.86]) and did not improve survival of septic shock patients (1.19 [0.85–1.67]). Independent variables with a significant impact on mortality included the use of extracorporeal membrane oxygenation (ECMO, 2.15 [1.68–2.76]) and CPR (1.60 [1.03–2.45]). The timing of the haemoadsorption therapy had no effect on patients´ outcomes. Due to inconclusive evidence for benefit and potential harm, haemoadsorption therapy should be limited to thoroughly designed clinical trials before introduced into clinical routine in the context of COVID-19.https://doi.org/10.1038/s41598-025-13860-0COVID-19Intensive care unitHaemoadsorptionIn-hospital mortalityCytokine adsorptionHyperinflammation |
| spellingShingle | Jan Andreas Kloka Thomas Jasny Oliver Old Elina Nürenberg-Goloub Christina Scharf Patrick Meybohm Alexander Supady Kai Zacharowski Benjamin Friedrichson Critical risks of haemoadsorption for COVID-19 patients and directions for future evaluations: a nationwide propensity score matched cohort study Scientific Reports COVID-19 Intensive care unit Haemoadsorption In-hospital mortality Cytokine adsorption Hyperinflammation |
| title | Critical risks of haemoadsorption for COVID-19 patients and directions for future evaluations: a nationwide propensity score matched cohort study |
| title_full | Critical risks of haemoadsorption for COVID-19 patients and directions for future evaluations: a nationwide propensity score matched cohort study |
| title_fullStr | Critical risks of haemoadsorption for COVID-19 patients and directions for future evaluations: a nationwide propensity score matched cohort study |
| title_full_unstemmed | Critical risks of haemoadsorption for COVID-19 patients and directions for future evaluations: a nationwide propensity score matched cohort study |
| title_short | Critical risks of haemoadsorption for COVID-19 patients and directions for future evaluations: a nationwide propensity score matched cohort study |
| title_sort | critical risks of haemoadsorption for covid 19 patients and directions for future evaluations a nationwide propensity score matched cohort study |
| topic | COVID-19 Intensive care unit Haemoadsorption In-hospital mortality Cytokine adsorption Hyperinflammation |
| url | https://doi.org/10.1038/s41598-025-13860-0 |
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