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Extracorporeal membrane oxygenation for critically ill patients with coronavirus-associated disease 2019: an updated perspective of the European experience.
Marullo, Antonino G; Cavarretta, Elena; Biondi Zoccai, Giuseppe; Mancone, Massimo; Peruzzi, Mariangela; Piscioneri, Fernando; Sartini, Patrizio; Versaci, Francesco; Morelli, Andrea; Miraldi, Fabio; Frati, Giacomo.
  • Marullo AG; Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy.
  • Cavarretta E; Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy.
  • Biondi Zoccai G; Mediterranea Cardiocentro, Naples, Italy.
  • Mancone M; Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy - giuseppe.biondizoccai@uniroma1.it.
  • Peruzzi M; Mediterranea Cardiocentro, Naples, Italy.
  • Piscioneri F; Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University, Latina, Italy.
  • Sartini P; Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy.
  • Versaci F; Mediterranea Cardiocentro, Naples, Italy.
  • Morelli A; Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University, Latina, Italy.
  • Miraldi F; Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University, Latina, Italy.
  • Frati G; Division of Cardiology, Santa Maria Goretti Hospital, Latina, Italy.
Minerva Cardioangiol ; 68(5): 368-372, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-125105
ABSTRACT

BACKGROUND:

Infection due to severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), i.e. coronavirus-associated disease 2019 (COVID-2019), may occasionally lead to acute respiratory distress syndrome (ARDS), requiring in the most severe cases extracorporeal membrane oxygenation (ECMO). Yet, limited data, if any, are currently available on the role of ECMO in critically ill patients with COVID-19. We aimed at providing a snapshot analysis of ECMO for COVID-19 in Europe.

METHODS:

Freely available data on ECMO in COVID-19 patients reported by the European Extracorporeal Life Support Organization (EuroELSO) were extracted and analyzed after conversion into long format. The primary outcome was the incidence of death during ECMO. Bootstrapping and logistic regression were used for inferential estimates.

RESULTS:

Details from a total of 333 patients treated in 90 institutions spanning 17 countries were obtained, with 22% women and mean age of 52 years. Death rate was 17.1% (95% confidence interval 13.1% to 21.1%), even if significant between-center differences were found, with some institutions reporting 100% case fatality. Exploratory inferential analysis showed no nominally statistically significant association between death and gender (P=0.788), but a significant association was found with age, mainly due to increased case fatality in subjects >60 years (odds ratio 4.80 [95% confidence interval 1.64 to 14.04], P=0.004).

CONCLUSIONS:

ECMO may play an important role in critically ill patients with COVID-19 refractory to less invasive treatments. The increased risk of early death in older patients may be used to prioritize ECMO indication in resource-conscious settings, if confirmed externally.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Extracorporeal Membrane Oxygenation / Critical Illness / Coronavirus Infections Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Minerva Cardioangiol Year: 2020 Document Type: Article Affiliation country: S0026-4725.20.05328-1

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Extracorporeal Membrane Oxygenation / Critical Illness / Coronavirus Infections Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Minerva Cardioangiol Year: 2020 Document Type: Article Affiliation country: S0026-4725.20.05328-1