Study suggests survival benefit for severely ill COVID-19 pa
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For critically ill COVID-19 patients treated with extracorporeal membrane oxygenation (ECMO), the risk of death remains high - but is much lower than suggested by initial studies, according to a report published by Annals of Surgery. The findings support the use of ECMO as "salvage therapy" for COVID-19 patients with acute respiratory distress syndrome (ARDS) or respiratory failure who do not improve with conventional mechanical ventilatory support.

This study analyzed the outcomes of COVID-19 patients with ARDS who were managed with extracorporeal membrane oxygenation (ECMO) across 155 US academic centers.

Using ICD-10 codes, data of patients with COVID-19 with ARDS, managed with ECMO between April - September 2020 were analyzed using the Vizient clinical database. Outcomes measured included in-hospital mortality, hospital and ICU length of stay (LOS), and direct cost. For comparative purposes, the outcome of a subset of COVID-19 patients aged between 18–64 years and managed with vs. without ECMO was examined.

Results were:
1,1182 patients with COVID-19 and ARDS received ECMO.

-- In-hospital mortality was 45.9%, mean LOS was 36.8 ± 24.9 days and mean ICU stay was 29.1 ± 17.3 days.

--In-hospital mortality, according to age group was 25.2% for 1-30 years; 42.2% for 31–50 years; 53.2% for 51–64 years; and 73.7% for ≥65 years.

--A subset analysis of COVID-19 patients, aged 18–64 years with ARDS requiring mechanical ventilation and managed with (n = 1113) vs without (n = 16,343) ECMO, showed relatively high in-hospital mortality for both groups.

In this large US study of patients with COVID-19 and ARDS managed with ECMO, the in-hospital mortality is high but much lower than initial reports.

Source: https://journals.lww.com/annalsofsurgery/Abstract/9000/Analysis_of_COVID_19_Patients_with_Acute.93599.aspx?utm_source=press&utm_medium=press&utm_campaign=sla_covid_pr_041221
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