EC Pulmonology and Respiratory Medicine

Background: The precise role of veno-venous extracorporeal membrane oxygenation (VV-ECMO) in managing patients with COVID-19-induced acute respiratory distress syndrome (ARDS) remains uncertain. Therefore, we examined the clinical progression and survival outcomes of severe COVID-19 patients and to identify the factors linked to survivability.

Methods: A retrospective study was conducted at a single center on severe COVID-19 patients with ARDS who were on mechanical ventilator support and were treated with VV-ECMO. The study evaluated baseline characteristics, ventilatory and ECMO parameters, pre-ECMO laboratory parameters, and demographics. A close follow-up was conducted for the first three months following hospital discharge, followed by regular check-ups extending to two to three years.

Results: The mean duration of mechanical ventilation before ECMO and meantime under ECMO were 6.8 ± 10.9 days and 35.5 ± 30.6 days, respectively. The hospital length of stay was 101.1 ± 73.95 days. The survival rate for patients on ECMO was 60%, while 50% of the patients having survived to date. The duration of hospital stays, time on ECMO and mechanical ventilation, and age were not associated with the survivability outcome of the patients.

Conclusion: The success rate of VV-ECMO in this study may encourage the widespread use of ECMO in severe COVID-19 pneumonia besides refractory to conventional ventilator support and other therapies. No significant predictive factors for the duration of ECMO support were identified, the decision to discontinue therapy should not be based solely on the length of ECMO treatment.

 Keywords: Severe COVID-19; Hypoxia; VV-ECMO; ARDS; Mechanical Ventilator; COVID-19 Mortality

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