Our findings indicate that TPE procedures can be conducted safely with UH and, when necessary, without anticoagulation. The use of LMWH was associated with more complications when compared with use of UH and to TPE done without anticoagulation. Further studies are necessary to study its use during TPE procedures.

Background The Seraph®100 Microbind Affinity Blood Filter® is a hemoperfusion device that is licensed for the reduction of pathogens, including several viruses, in the blood. It received Emergency Use Authorization (EUA) for the treatment of severe coronavirus disease 2019 (COVID-19) by the FDA. Several studies have shown that the blood viral load of SARS-CoV-2 correlates with adverse outcomes and removal of the nucleocapsid of the SARS-CoV-2 virus by the Seraph®100 has been recently demonstrated. The aim of this registry was to evaluate safety and efficacy of Seraph®100 treatment for COVID-19 patients. Methods Twelve hospitals from six countries representing two continents documented patient and treatment characteristics as well as outcome parameters without reimbursement. Additionally, mortality and safety results of the device were reported. One hundred-and-two treatment sessions in 82 patients were documented in the registry. Four patients were excluded from mortality analysis due to incomplete outcome data, which were available in the other 78 patients. Results Overall, a 30-day mortality rate of 46.2% in the 78 patients with complete follow up was reported. Median treatment time was 5.00 [4.00–13.42] h. and 43.1% of the treatments were performed as hemoperfusion only. Adverse events of the Seraph®100 treatment were reported in 8.8% of the 102 treatments and represented premature end of treatment due to circuit failure. Patients that died were treated later in their ICU stay and onset of COVID symptoms. They also had higher ferritin levels. Multivariate Cox regression revealed that delayed Seraph®100 treatment after ICU admission (>60 hours) as well as bacterial superinfection were associated with mortality. While average predicted mortality rate according to SOFA score in ICU patients was 56.7% the observed mortality was 50.7%. In non-ICU patients 4C-Score average predicted a mortality rate of 38.0% while the observed mortality rate was 11.1% Conclusions The treatment of COVID-19 patients with Seraph®100 is well tolerated and the circuit failure rate was lower than previously reported for KRT in COVID-19 patients. Mortality corelated with late initiation of Seraph treatment after ICU admission and bacterial superinfection infection. Compared to predicted mortality according to 4C-Score and SOFA Score, mortality of Seraph®100 treated patients reported in the registry was lower.

This study tried to investigate the impact of oXiris filter on both clinical and laboratory parameters in critically‐ill COVID‐19 intensive care unit (ICU) patients receiving extracorporeal blood purification and the clinical setting for the initiation of therapy. A consecutive sample of 15 ICU patients with COVID‐19 was treated with oXiris membrane for blood purification or for support of renal function due to acute kidney injury. We have included 19 non treated ICU COVID‐19 patients as a control group. Two chest x‐rays were analyzed for determining the chest x‐ray severity score. We have found a significant decrease of SOFA score, respiratory status improved and the chest x‐ray severity score was significantly decreased after 72 h of treatment. IL‐6 significantly decreased after 72 h of treatment while other inflammatory markers did not. Respiratory status in the control group worsened as well as increase in SOFA score and chest x‐ray severity score. Survived patients have shorter time from the onset of symptoms before starting with extracorporeal blood purification treatment and shorter time on vasoactive therapy and invasive respiratory support than deceased patients. Critically‐ill patients with COVID‐19 treated with extracorporeal blood purification survived significantly longer than other ICU COVID‐19 patients. Treatment with oXiris membrane provides significant reduction of IL‐6, leads to improvement in respiratory status, chest x‐ray severity score, and reduction of SOFA score severity. Our results can suggest that ICU COVID‐19 patients in an early course of a disease could be potentially a target group for earlier initiation of extracorporeal blood purification.

Sexual dysfunction (SD) is common in men and women with chronic kidney disease (CKD) and is considered as an early marker for cardiovascular (CV) disease. We hypothesized that patients with SD have higher risk for vascular damage of the large arteries, accelerated vascular aging, and consequently higher CV mortality than other end-stage renal disease (ESRD) patients. In this study, the International Index of Erectile Function (IIEF) questionnaire and the Female Sexual Function Index (FSFI) questionnaire were applied in men and women, respectively. Ambulatory blood pressure monitoring (ABPM), arterial stiffness, and ankle-brachial index (ABI) were performed in all patients. Pulse wave velocity (PWV) was significantly slower in non-SD patients (10.5 vs. 8.8 m/s; p < 0.001) with significantly lower number of non-SD patients with PWV > 10 m/s compared to SD patients (p < 0.001). Only 57% of the patients with prior CV event had PWV > 10 m/s. No difference in AIx was observed. Non-SD patients had better values of ABI (0.83 vs. 1.09; p < 0.05) with significantly lower number of non-SD patients with ABI < 0.9 compared to SD patients (p = 0.001) as well as smaller percentage of LVH (57.5% vs. 80.7%; p = 0.01). There were no differences in hemodynamic parameters when patients with SD were divided by sex. Pulse wave velocity was the strongest predictor of lower IIEF and FSFI scores. Mean survival time was longer in non-SD patients than in SD patients (11.6 vs. 10.5 months, p = 0.019). The higher incidence of prior CV events and CV mortality found in SD patients on hemodialysis (HD) is a consequence of accelerated vascular aging. Sexual dysfunction in HD patients should also be considered a marker of subclinical organ damage and future CV events. Our study confirms the predictive role of PWV in HD patients.