With great interest we read the article by Convertino et al. discussing potential treatment targets for pharmacological immunomodulation in coronavirus disease 2019 (COVID-19) with acute respiratory distress syndrome (ARDS). We would like to add to the debate some thoughts about cytokine adsorption, which was mentioned only in passing in this discussion.

Following initial reports describing Interleukin-6 (IL-6) as a predictive factor for a negative outcome, extracorporeal cytokine adsorption was discussed as a possible treatment option for severe COVID-19 cases.

Initial experience at our center using the CytoSorb® device (CytoSorbents Europe, Berlin, Germany) in combination with veno-venous extracorporeal membrane oxygenation (V-V ECMO) in severe COVID-19 yielded promising results; cytokine adsorption resulted in a more pronounced decrease of IL-6 after initiation of V-V ECMO as compared to patients treated without cytokine adsorption.

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