SARS-CoV-2 Versus Influenza-associated Acute Respiratory Distress Syndrome Requiring Veno-venous Extracorporeal Membrane Oxygenation Support. Issue 2 (February 2021)

• Record Type: Journal Article
• Authors: Cousin, Nicolas; Bourel, Claire; Carpentier, Dorothee; Goutay, Julien; Mugnier, Agnes; Labreuche, Julien; Godeau, Elise; Clavier, Thomas; Grange, Steven; Tamion, Fabienne; Durand, Arthur; Moussa, Mouhamed D.; Duburcq, Thibault
• Is Part Of: ASAIO journal. Volume 67:Issue 2(2021)
• Publication Date: 2021-02
• Subjects: COVID-19 -- acute respiratory distress syndrome -- extracorporeal membrane oxygenation -- influenza; Artificial organs -- Periodicals; 617
• DOI: 10.1097/MAT.0000000000001325
• Languages: English
• ISSNs: 1058-2916

Abstract

Abstract : No study has compared patients with COVID-19-related refractory ARDS requiring veno-venous extracorporeal membrane oxygenation (V-V ECMO) to a relevant and homogenous control population. We aimed to compare the outcomes, the clinical characteristics, and the adverse effects of COVID-19 patients to a retrospective cohort of influenza patients. This retrospective case-control study was conducted in the ICUs of Lille and Rouen University Hospitals between January 2014 and May 2020. Two independent cohorts of patients with ARDS requiring V-V ECMO infected with either COVID-19 (n = 30) or influenza (n = 22) were compared. A 3-month follow-up was completed for all patients. Median age of COVID-19 and influenza patients was similar (57 vs. 55 years; p = 0.62). The 28-day mortality rate did not significantly differ between COVID-19 (43.3%) and influenza patients (50%, p = 0.63). There was no significant difference considering the cumulative incidence of ECMO weaning, hospital discharge, and 3-month survival. COVID-19 patients had a lower SAPS II score (58 [37–64] vs. 68 [52–83]; p = 0.039), a higher body mass index (33 [29–38] vs . 30 [26–34] kg/m 2 ; p = 0.05), and were cannulated later (median delay between mechanical support and V-V ECMO 6 vs. 3 days, p = 0.004) compared with influenza patients. No difference in overall adverse events was observed between COVID-19 and influenza patients (70% vs. 95.5% respectively; p = 0.23). Despite differences in clinical presentation before V-V ECMO implantation, 28-day and 3-month mortality rate did not differ between COVID-19 and influenza patients. Considering the lack of specific treatment for COVID-19, V-V ECMO should be considered as a relevant rescue organ support.