Background: In current pandemic of
COVID-19 MESHD, approximately 15% to 30% of critically ill
COVID-19 MESHD patients developed
acute respiratory distress syndrome MESHD (
ARDS MESHD) with a high mortality. Extracorporeal membrane of oxygenation (ECMO) provides direct support for both lung and heart in
ARDS MESHD. However, the role of ECMO in
COVID-19 MESHD related
ARDS MESHD was still controversial. The aim of this study was to provide insights into the mortality, intensive care unit (ICU) management, risk factors for mortality, 180-day short term prognosis of the
COVID-19 MESHD related severe
ARDS MESHD patients receiving ECMO treatment. Methods: From Feb 2nd, 2020 to April 27th, 2020, we included adult
COVID-19 MESHD related
ARDS MESHD patients admitted to intensive care unit in Tongji Hospital. Totally, 53 patients were retrospectively analyzed. They were divided into ECMO (mechanical ventilation with ECMO, n=16) and non-ECMO group (mechanical ventilation, n=37). The primary outcome was all-cause 60-day mortality. The secondary outcomes were complications on ECMO, successful weaning from ECMO, and all-cause 180-day mortality. Results: The all-cause 60-day mortality was 37.5% (6/16) in ECMO group and 86.5% (32/37) in non-ECMO group (HR, 0.196; 95% CI, 0.053-0.721; p=0.014). 10 (62.5%) patients were successfully weaned from ECMO. The all-cause 180-day mortality was 56.3% (9/16) in ECMO group and 33 (89.2%, 33/37) in non-ECMO group (HR, 0.298; 95% CI, 0.130-0.680; p=0.004). All the patients in ECMO group suffered from at least one device-related complication with
coagulopathy MESHD (81.3%) being most frequently seen. Up to 180-day follow up after disease onset, the ECMO-treated survivors maintained good quality of life without severe complications or disabilities.
Hypercapnia MESHD,
thrombopenia MESHD,
myocardial injury MESHD and elevation of
IL-8 HGNC and
IL-10 HGNC during ECMO treatment were strongly associated with
death MESHD.Conclusion: This study showed the
COVID-19 MESHD patients significantly benefited from ECMO treatment during severe
ARDS MESHD, which supported the application of ECMO as an indicated strategy in the management of
COVID-19 MESHD related
ARDS MESHD.