Multi-Institutional Analysis of 505 COVID-19 Patients Supported with ECMO: Predictors of Survival

On February 18, 2022, The Annals of Thoracic Surgery published an important manuscript titled: “Multi-institutional Analysis of 505 COVID-19 Patients Supported with ECMO: Predictors of Survival”. The purpose of this study was to review the clinical experience in 505 patients at 45 hospitals in 22 states with confirmed COVID-19 who were supported with ECMO and to estimate risk factors for mortality. SpecialtyCare created and utilized a multi-institutional database to assess patients supported with and separated from ECMO between March 17, 2020 and October 11, 2021.

Patient characteristics that were analyzed included pre-COVID-19 risk factors and comorbidities, confirmation of COVID-19 diagnosis, features of ECMO support, specific medications used to treat COVID-19, and short-term outcomes through hospital discharge.

Patient care teams at each of the 45 contributing hospitals determined the criteria for placement on ECMO. All patients placed on ECMO were diagnosed with COVID-19 with severe respiratory failure deemed resistant to conventional management. Each ECMO team determined the mode of ECMO and the cannulation strategy.

Results of this study showed that the median time on ECMO was 18 days. Of the 505 patients, 194 survived and 311 died. Veno-venous ECMO had a 39.5% survival rate and veno-arterial ECMO had a 26.7% survival rate. Results also showed that survivors had a lower median age and shorter median time on ECMO from diagnosis to intubation. This study concludes that “ECMO facilitates salvage and survival of select critically ill patients with COVID-19.” The publication also states that “lessons learned from the use of ECMO to support patients with COVID-19 will inform the management of other patients with different forms of severe respiratory failure.”

Congratulations to our awesome SpecialtyCare team: Eric A. Tesdahl, PhD, Anthony K. Sestokas, PhD, Alfred H. Stammers, MSA, Linda B. Mongero, CCP, Kirti Patel, CCP, and Tom Coley, CCP.