Critical Care Explorations (Apr 2022)

A Multicenter Evaluation of the Seraph 100 Microbind Affinity Blood Filter for the Treatment of Severe COVID-19

  • Stephen A. Chitty, MD,
  • Sarah Mobbs, FNP-BC,
  • Brian S. Rifkin, MD,
  • Steven W. Stogner, MD,
  • Michael S. Lewis, MD,
  • Jaime Betancourt, MD,
  • Jeffrey DellaVolpe, MD,
  • Fadi Abouzahr, MD,
  • Andrew M. Wilhelm, DO,
  • Harold M. Szerlip, MD,
  • Amay Parikh, MD,
  • Robert M. Gaeta, DO,
  • Ian Rivera, MD,
  • Caroline Park, MD, MPH,
  • Benjamin Levi, MD,
  • George L. Anesi, MD, MSCE, MBE,
  • Karl C. Alcover, PhD,
  • Thomas B. Arnold, BA,
  • Jeffrey T. Howard, PhD,
  • Kumar Sharma, MD,
  • Kathleen P. Pratt, PhD,
  • Ian J. Stewart, MD,
  • Kevin K. Chung, MD,
  • for the PURIFY Investigators,
  • Amay Parikh,
  • Sarah Guyler,
  • Harold Szerlip,
  • Giselle Carino,
  • Tanqunisha Coleman,
  • Robert J. Walter,
  • Mai Nguyen,
  • Robert Gaeta,
  • Ian M. Rivera,
  • Ferdinand Bacomo,
  • Sean C. Reilly,
  • Susan D. Rogers,
  • Delia Marshall,
  • Melba Francis,
  • Sholanda Henderson,
  • Bob Ward,
  • Keith McCrea,
  • Erdie de Peralta,
  • Lakhmir S. Chawla,
  • Andrea Worsham,
  • Michael Benjamin,
  • Brian Rifkin,
  • Steven Stogner,
  • Steve Farrell,
  • Karen Brooks,
  • Maria Voelkel,
  • Sophie Haralson,
  • Marianne Spevak,
  • Daniell Clark,
  • Laura Osgood,
  • Qianru Wu,
  • Kevin Grant,
  • Rittal Mehta,
  • Jeffrey Dellavolpe,
  • Fadi Abouzahr,
  • Mohammed Ahmed,
  • Ginger Dowell,
  • Stephen Amerson,
  • Stephen Chitty,
  • Srah Mobbs,
  • Gwen Gratto-Cox,
  • Christy Jordan,
  • George Peoples,
  • Dan Hargrove,
  • Karen Arrington,
  • Lauren Zahra,
  • Jessica Raley,
  • Katie Lyon,
  • Rachel Macomber,
  • Ashlee Richie,
  • Tineka Brown,
  • Laura Richie,
  • Susan Hargrove,
  • Emily Scribe,
  • Steven White,
  • Kevin Chung,
  • Ian Stewart,
  • Kathleen Pratt,
  • Karl Alcover,
  • Thomas B. Arnold,
  • Lauren Walker,
  • Amy Laczek,
  • Breandan Sullivan,
  • Nick Naughton,
  • Sabrina Espinoza,
  • Vikhyat Bebarta,
  • Adit Ginde,
  • Anip Bansal,
  • Ilona Dewald,
  • Isidro Susano Basilio,
  • Andrew Wilhelm,
  • Delia Owens,
  • George L. Anesi,
  • Kumar Sharma,
  • Subrata Debnath,
  • Sean P. Barnett,
  • Nicholas S. Niazi,
  • Jeffrey Howard,
  • Benjamin Levi,
  • Caroline Park,
  • Tamim Hamdi,
  • Peiman Lahsaei,
  • Nilum Rajora,
  • Christopher Choi,
  • Andriy I Batchinsky,
  • Michael Lewis,
  • Jaime Betancourt,
  • Nancy Mohler,
  • Natalia Dudek,
  • Jasmine Bagnas,
  • James Oliver,
  • Stephen Olson,
  • Jenny Nguyen

DOI
https://doi.org/10.1097/CCE.0000000000000662
Journal volume & issue
Vol. 4, no. 4
p. e0662

Abstract

Read online

OBJECTIVES:. The Seraph100 Microbind Affinity Blood Filter (Seraph 100) (ExThera Medical, Martinez, CA) is an extracorporeal therapy that can remove pathogens from blood, including severe acute respiratory syndrome coronavirus 2. The aim of this study was to evaluate safety and efficacy of Seraph 100 treatment for COVID-19. DESIGN:. Retrospective cohort study. SETTING:. Nine participating ICUs. PATIENTS:. COVID-19 patients treated with Seraph 100 (n = 53) and control patients matched by study site (n = 53). INTERVENTION:. Treatment with Seraph 100. MEASUREMENTS AND MAIN RESULTS:. At baseline, there were no differences between the groups in terms of sex, race/ethnicity, body mass index, and need for mechanical ventilation. However, patients in the Seraph 100 group were younger (median age, 54 yr; interquartile range [IQR], 41–65) compared with controls (median age, 64 yr; IQR, 56–69; p = 0.009). Charlson comorbidity index scores were lower in the Seraph 100 group (2; IQR, 0–3) compared with the control group (3; IQR, 2–4; p = 0.006). Acute Physiology and Chronic Health Evaluation II scores were also lower in Seraph 100 subjects (12; IQR, 9–17) compared with controls (16; IQR, 12–21; p = 0.011). The Seraph 100 group had higher vasopressor-free days with an incidence rate ratio of 1.30 on univariate analysis. This difference was not significant after adjustment. Seraph 100-treated subjects were less likely to die compared with controls (32.1% vs 64.2%; p = 0.001), a difference that remained significant after adjustment. However, no difference in mortality was observed in a post hoc analysis utilizing an external control group. In the full cohort of 86 treated patients, there were 177 total treatments, in which only three serious adverse events were recorded. CONCLUSIONS:. Although this study did not demonstrate consistently significant clinical benefit across all endpoints and comparisons, the findings suggest that broad spectrum, pathogen agnostic, blood purification can be safely deployed to meet new pathogen threats while awaiting targeted therapies and vaccines.