Supplementary Material for: The efficacy of hemoperfusion in severe COVID-19 patients: A systematic review and meta-analysis

Objective: The objective of this study was to conduct a meta analysis and systematic review to assess the efficacy of the hemoperfusion in patients with severe COVID-19. Data Sources: A comprehensive search for candidate publications was performed using PubMed, Cochrane Library, and Embase. Study Selections: Studies investigating the effect of hemoperfusion on mortality among severe COVID-19 patients were selected, including randomized controlled trials(RCTs), non-randomized controlled trials, and observational studies with control groups. The primary endpoint was the longest reported mortality, while the secondary endpoints were the length of stay, ICU stay, P/F ratio, and CRP. Data Extraction: The Cochrane test (Q) and Isquare (I2) test were used to quantify heterogeneity among the studies. The fixedeffect model (Mantel–Haenszel method) would be selected when there is no heterogeneity (P > 0.10 and I2 0.05; I2 = 68.2%). The results of the subgroup analysis of hemoperfusion with HA series indicated a reduction in the mortality of patients with COVID-19 (RR 0.60 [0.46, 0.78]; p < 0.0001; I2 =0.0%). The hemoperfusion (HP) group had a longer length of stay compared with the control group (WMD 5.25[2.53, 7.97]days; p < 0.05; I2 = 28.0%), but not the ICU stay (ES 1.33[-2.86, 5.53]days; p = 0.53; I2 = 85.5%). After hemoperfusion, the P/F ratio (WMD 95.79[74.46, 117.12]mmHg; p < 0.05; I2 = 5.8%) increased, while CRP (WMD -44.03[-68.97, -19.09]mg/L; p < 0.05; I2 = 86.9%) decreased.

研究目的：本研究旨在开展一项荟萃分析与系统综述，评估血液灌流（hemoperfusion）对重症新型冠状病毒肺炎（COVID-19）患者的临床疗效。数据来源：通过PubMed、Cochrane Library及Embase数据库全面检索候选相关文献。研究筛选：纳入探究血液灌流对重症COVID-19患者死亡率影响的相关研究，包括随机对照试验（randomized controlled trials, RCTs）、非随机对照试验及设有对照组的观察性研究。本研究的主要结局指标为最长随访周期内报告的死亡率，次要结局指标包括总住院时长、重症监护病房（ICU）停留时长、动脉血氧分压/吸入氧浓度比值（P/F ratio）及C反应蛋白（CRP）。数据提取与统计分析：采用Cochrane Q检验与I²（Isquare）检验量化各研究间的异质性。当无异质性时（P > 0.10且I²=0.05；I²=68.2%），将选用固定效应模型（Mantel–Haenszel法）。HA系列血液灌流亚组分析结果显示，其可降低COVID-19患者的死亡率（相对风险RR=0.60，95%置信区间[0.46, 0.78]；p<0.0001；I²=0.0%）。血液灌流组患者的总住院时长较对照组更长（加权均数差WMD=5.25，95%置信区间[2.53, 7.97]天；p<0.05；I²=28.0%），但ICU停留时长无统计学差异（效应量ES=1.33，95%置信区间[-2.86, 5.53]天；p=0.53；I²=85.5%）。接受血液灌流治疗后，患者的P/F比值显著升高（加权均数差WMD=95.79，95%置信区间[74.46, 117.12]mmHg；p<0.05；I²=5.8%），而CRP水平显著降低（加权均数差WMD=-44.03，95%置信区间[-68.97, -19.09]mg/L；p<0.05；I²=86.9%）。