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Severe forms of the coronavirus disease 2019 (COVID-19) can progress to sepsis-like complications accompanied by "cytokine storm" for which the most effective treatment has not yet been established. Our study describes the results of CytoSorb hemoadsorption in COVID-19 patients treated on the intensive care unit (ICU). In this retrospective study, 26 patients with COVID-19 and acute respiratory distress syndrome (ARDS) were treated with hemoadsorption therapy. Pre-, and post-treatment values (clinical and laboratory) were compared. Data are expressed as mean (confidence intervals, CI), or median [interquartile ranges, IQR], as appropriate. Patients received 2 hemoadsorption treatments. This resulted in a significant decrease in norepinephrine requirements, and inflammatory marker plasma concentrations (procalcitonin, C-reactive protein, ferritin) when comparing pre versus post treatment levels. The PaO 2 /FiO 2 and overall organ function (ie, Sequential Organ Failure Assessment-SOFA score) also improved significantly. Patients stayed on the ICU for 9 days and 21 of them survived. To the best of our knowledge, this is one of the largest case series to date reporting early experiences on extracorporeal hemoadsorption therapy in SARS-CoV-2 positive patients with hyperinflammation and moderate ARDS. Treatment proved to be effective, technically feasible and well-tolerated., (© 2021 International Center for Artificial Organs and Transplantation and Wiley Periodicals LLC.)

Background: Despite 2.5 million infections and 169,000 deaths worldwide (as of April 20, 2020), no maternal deaths and only a few pregnant women afflicted with severe respiratory morbidity have been reported to be related to COVID-19 disease. Given the disproportionate burden of severe and fatal respiratory disease previously documented among pregnant women following other coronavirus-related outbreaks (SARS-CoV in 2003 and MERS-CoV in 2012) and influenza pandemics over the last century, the absence of reported maternal morbidity and mortality with COVID-19 disease is unexpected., Objective: To describe maternal and perinatal outcomes and death in a case series of pregnant women with COVID-19 disease., Study Design: We describe here a multiinstitution adjudicated case series from Iran that includes 9 pregnant women diagnosed with severe COVID-19 disease in their second or third trimester. All 9 pregnant women received a diagnosis of SARS-CoV-2 infection by reverse transcription polymerase chain reaction nucleic acid testing. Outcomes of these women were compared with their familial/household members with contact to the affected patient on or after their symptom onset. All data were reported at death or after a minimum of 14 days from date of admission with COVID-19 disease., Results: Among 9 pregnant women with severe COVID-19 disease, at the time of reporting, 7 of 9 died, 1 of 9 remains critically ill and ventilator dependent, and 1 of 9 recovered after prolonged hospitalization. We obtained self-verified familial/household cohort data in all 9 cases, and in each and every instance, maternal outcomes were more severe compared with outcomes of other high- and low-risk familial/household members (n=33 members for comparison)., Conclusion: We report herein maternal deaths owing to COVID-19 disease. Until rigorously collected surveillance data emerge, it is prudent to be aware of the potential for maternal death among pregnant women diagnosed as having COVID-19 disease in their second or third trimester., (Copyright © 2020 Elsevier Inc. All rights reserved.)