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Characteristics and Outcomes of COVID-19 Patients Supported by Venoarterial or Veno-Arterial-Venous Extracorporeal Membrane Oxygenation.
Haroun, Magued W; Patel, Snehal R; Sims, Daniel B; Jorde, Ulrich P; Goldstein, Daniel J; Saeed, Omar.
  • Haroun MW; Department of Hospital Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
  • Patel SR; Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
  • Sims DB; Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
  • Jorde UP; Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
  • Goldstein DJ; Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
  • Saeed O; Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY. Electronic address: osaeed@montefiore.org.
J Cardiothorac Vasc Anesth ; 36(8 Pt B): 2935-2941, 2022 08.
Article in English | MEDLINE | ID: covidwho-1665734
ABSTRACT

OBJECTIVES:

Cardiac injury has been reported in up to 20%-to-30% of patients with COVID-19, and severe disease can lead to cardiopulmonary failure. The role of mechanical circulatory support in these patients remains undetermined. The authors here aimed to determine the characteristics and outcomes of patients with COVID-19 requiring venoarterial extracorporeal membrane oxygenation (VA ECMO) or veno-arterial-venous (VAV) ECMO support. DESIGN AND

SETTING:

A multicenter, retrospective case series.

PARTICIPANTS:

The cohort consisted of adult patients (18 years of age and older) with confirmed COVID-19 requiring VA ECMO or VAV ECMO support in the period from March 1, 2020, to April 30, 2021. Outcomes were recorded until July 31, 2021. MEASUREMENTS AND MAIN

RESULTS:

To show factors related to death during hospitalization, patients were grouped as survivors and nonsurvivors. Kaplan-Meier analysis was used to estimate 90-day in-hospital mortality. Overall, 37 patients from 12 centers comprised the study cohort. The median patient age was 44 years old (interquartile range [IQR], 35-52), and 12 (32%) were female patients. The duration of ECMO support ranged from 2-to-132 days. At the end of the follow-up period, 13 patients (35%) were discharged or transferred alive, and 24 patients (65%) died during the hospitalization. The cumulative in-hospital mortality at 90 days was 64% (95% confidence interval 47-81). During the time from intubation to VA ECMO or VAV ECMO initiation (1 day [IQR 0-7.5] v 6 days [IQR 2.5-14], p = 0.0383), body mass index (32 [IQR 26-36] v 37 [IQR 33-40], p = 0.009), and baseline C-reactive protein (7.15 v 38.9 mg/dL, p = 0.009) were higher in those who expired.

CONCLUSION:

Only one-third of the patients with COVID-19 requiring VA ECMO or VAV ECMO survived to discharge. Close monitoring of at-risk patients with early initiation of ECMO with circulatory support may further improve outcomes.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Extracorporeal Membrane Oxygenation / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Variants Limits: Adolescent / Adult / Female / Humans / Male Language: English Journal: J Cardiothorac Vasc Anesth Journal subject: Anesthesiology / Cardiology Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Extracorporeal Membrane Oxygenation / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Variants Limits: Adolescent / Adult / Female / Humans / Male Language: English Journal: J Cardiothorac Vasc Anesth Journal subject: Anesthesiology / Cardiology Year: 2022 Document Type: Article