Characteristics and outcomes in extracorporeal membrane oxygenation support in covid-19 patients: A nationwide cohort-study in Argentina

ABSTRACT

This retrospective multicentre study analyzes epidemiological characteristics, ventilatory mechanics, ECMO settings and outcomes in adult COVID-19 patients treated with ECMO during the first surge in Argentina. The data is obtained from 26 out of 34 patients (76%), representing 4 out of 7 ECMO centers that treated COVID-19 patients. 49 requests for ECMO were received during the study period but 23 were rejected for clinical reasons. 26 patients received ECMO and entered the analysis. Patients were mainly males (80%), aged 50 (IQR 39-60), APACHE 2 10.5 (IQR7,7-16) SOFA 5.5 (IQR 4-8). Mortality during ECMO support was 42 3% (n = 11) while overall hospital mortality was 65 3% (n = 17). Median time from mechanical ventilation to ECMO was 5 days (IQR 2 5-8) vs median 6 days (RIQ 3 5-10 5);p=0 46 for survivors and non survivors respectively. However, time from symptoms onset to ECMO was 14 5 days (IQR 10 7-21 5);with statistically significant differences between survivors and non-survivors [11 days (IQR 9 5-15 5) vs 17 days [IQR 12 5-27] days;p=0 039). Additionally, survivors were characterized by higher baseline respiratory system compliance 31,8 (29-45) vs 22,5 (17-28,5) p<0.001) lower driving pressure 12 vs 18 p<0.001, lower ferritin levels 600 (399-1146) vs 1604 (772-2384) p0.04 and higher platelet count 346100 (248850-409800) vs 273400 (172000-308000) p0.04 Non-survivors were characterized by a longer course of disease pre ECMO, and severe pro-inflammatory profile associated with a more advanced and severe lung damage.