Six Month Mortality in Patients with COVID-19 and Non-COVID-19 Viral Pneumonitis Managed with Veno-Venous Extracorporeal Membrane Oxygenation. Issue 9 (18th June 2021)

• Record Type: Journal Article
• Authors: Garfield, Benjamin; Bianchi, Paolo; Arachchillage, Deepa; Hartley, Philip; Naruka, Vinci; Shroff, Diana; Law, Alexander; Passariello, Maurizio; Patel, Brijesh; Price, Susanna; Rosenberg, Alexander; Singh, Suveer; Trimlett, Richard; Xu, Tina; Doyle, James; Ledot, Stephane
• Is Part Of: ASAIO journal. Volume 67:Issue 9(2021)
• Page Start: 982
• Page End: 988
• Publication Date: 2021-06-18
• Subjects: COVID-19 -- acute respiratory distress syndrome -- viral pneumonia -- extracorporeal membrane oxygenation; Artificial organs -- Periodicals; 617
• DOI: 10.1097/MAT.0000000000001527
• Languages: English
• ISSNs: 1058-2916

Abstract

Abstract : A significant proportion of patients with COVID-19 develop acute respiratory distress syndrome (ARDS) with high risk of death. The efficacy of veno-venous extracorporeal membrane oxygenation (VV-ECMO) for COVID-19 on longer-term outcomes, unlike in other viral pneumonias, is unknown. In this study, we aimed to compare the 6 month mortality of patients receiving VV-ECMO support for COVID-19 with a historical viral ARDS cohort. Fifty-three consecutive patients with COVID-19 ARDS admitted for VV-ECMO to the Royal Brompton Hospital between March 17, 2020 and May 30, 2020 were identified. Mortality, patient characteristics, complications, and ECMO parameters were then compared to a historical cohort of patients with non-COVID-19 viral pneumonia. At 6 months survival was significantly higher in the COVID-19 than in the non-COVID-19 viral pneumonia cohort (84.9% vs. 66.0%, p = 0.040). Patients with COVID-19 had an increased Murray score (3.50 vs. 3.25, p = 0.005), a decreased burden of organ dysfunction (sequential organ failure score score [8.76 vs. 10.42, p = 0.004]), an increased incidence of pulmonary embolism (69.8% vs. 24.5%, p < 0.001) and in those who survived to decannulation longer ECMO runs (19 vs. 11 days, p = 0.001). Our results suggest that survival in patients supported with EMCO for COVID-19 are at least as good as those treated for non-COVID-19 viral ARDS.