ASSOCIATION BETWEEN ETHNICITY AND COVID-19 PATIENTS TREATED WITH EXTRACORPOREAL MEMBRANE OXYGENATION

ABSTRACT

SESSION TITLE Impact of Health Disparities and Differences SESSION TYPE Rapid Fire Original Inv PRESENTED ON 10/19/2022 1115 am - 1215 pm PURPOSE: As of March 25, 2022, age-standardized data reported by the Centers for Disease Control and Prevention showed that Hispanic, Black and American Indian or Alaska Native are about twice as likely to die from coronavirus disease 2019 (COVID-19) as their White and Asian counterparts. However, there is paucity of data regarding the effect of race on outcomes in COVID-19 related acute respiratory distress syndrome (ARDS) patients managed with extracorporeal membrane oxygenation (ECMO). Our study aims to understand the differences in the outcome between White/Asian and other ethnically minority COVID-19 patients treated with ECMO in our intensive care unit (ICU). METHODS: Retrospective analysis of adult patients with COVID-19 related ARDS treated with ECMO in the ICUs of a quaternary care hospital between 03/01/2020 and 03/31/2022. Patients were divided into two groups White/Asian (WA) and Other Minorities (OM). Demographics, clinical characteristics, and outcomes of the two groups were compared. RESULTS: Of the 36 COVID-19 patients managed with ECMO during the study period, 18 (50%) patients belonged to the WA group while 18 (50%) patients belonged to the OM group. In the WA group, 16 (89%) were white and 2 (11%) were Asians whereas in the OM group, 16 (89%) patients were Hispanics and 2 (11%) patients were African-American. Both groups were similar in terms of age, gender, comorbidity burden (measured by Charlson Comorbidity Index), and severity of illness at the time of ICU admission (assessed by APACHE-IV score). Mean RESP score was lower in the OM group but was not statistically significant (1.3 ± 3.9 vs 2.9 ± 2.3, p= 0.157). This was reflected in the higher hospital mortality in the OM group compared to the WA group [n= 9 (50%) vs. 15 (83%), p=0.075]. There was no significant difference between the groups in the rate of ECMO-related complications, including major bleeding requiring transfusion, transaminitis (alanine transaminase greater than 5 times of upper normal limit), stroke, myocardial dysfunction (defined as an ejection fraction < 30%), acute kidney injury requiring dialysis and positive sterile fluid cultures. CONCLUSIONS: Our study showed higher mortality in ethnically minority patients compared to the white and Asian population but the difference was not statistically significant. It is possible that the relatively small number of patients in our study led to a beta error. Higher mortality rates among people of color have been attributed to low socio-economic status, structural inequities in health care and differences in vaccination rates. CLINICAL IMPLICATIONS Larger studies are needed to further explore differences in clinical characteristics and outcomes of COVID-19 patients of different races and ethnicities treated with ECMO. DISCLOSURES No relevant relationships by ALEENA ARSHAD No relevant relationships by Dipak Chandy No relevant relationships by Subo Dey No relevant relationships by Oleg Epelbaum No relevant relationships by Daniel Greenberg No relevant relationships by Theresa Henson No relevant relationships by Lawrence Huang No relevant relationships by Daniel Peneyra No relevant relationships by Areen Pitaktong No relevant relationships by Hamid Yaqoob