In-hospital and Post-discharge Status in COVID-19 Patients with Acute Respiratory Failure Supported with Extracorporeal Membrane Oxygenation

• Main Authors: Baracioli, L.M (Author), Costa, L.D.V (Author), Dias, M.R.S (Author), Drager, L.F (Author), Fernandes, H.M (Author), Franci, A. (Author), Galas, F.R.B.G (Author), Kalil-Filho, R. (Author), Moraes, J.G (Author), Mourão, M.M (Author), Nascimento, T.C.D.C (Author), Patore, L. (Author), Rosario, A.L (Author), Saretta, R. (Author)
• Format: Article
• Language: English
• Published: Lippincott Williams and Wilkins 2023
• Subjects: acute respiratory distress syndrome; Acute respiratory distress syndrome; aftercare; Aftercare; aged; Aged; Confidence interval; coronavirus disease 2019; COVID-19; critical care; Critical care; extracorporeal membrane oxygenation; Extracorporeal membrane oxygenation; Extracorporeal Membrane Oxygenation; extracorporeal oxygenation; hospital; hospital discharge; Hospital discharge; Hospital mortality; Hospitals; human; Humans; Latin americans; Oxygenation; Patient Discharge; Post-acute coronavirus disease 2019 syndrome; post-acute COVID-19 syndrome; Postdischarges; Quality control; quality of life; Quality of Life; respiratory distress syndrome; Respiratory Distress Syndrome; respiratory failure; Respiratory failure; Respiratory Insufficiency; Respiratory therapy; Ventilation
• Online Access: View Fulltext in Publisher

 Few data from Latin American centers on clinical outcomes in coronavirus disease 2019 (COVID-19) patients with acute respiratory distress syndrome who required extracorporeal membrane oxygenation (ECMO) are published. Moreover, clinical and functional status after hospital discharge remains poorly explored in these patients. We evaluated in-hospital outcomes of severe COVID-19 patients who received ECMO support in two Brazilian hospitals. In one-third of the survivors, post-acute COVID-19 syndrome (PACS), quality of life, anxiety, depression, and return to work were evaluated. Eighty-five patients were included and in-hospital mortality was 47%. Age >65 years (HR: 4.8; 95% confidence interval [CI]: 1.4-16.4), diabetes (HR: 6.0; 95% CI: 1.8-19.6), ECMO support duration (HR: 1.08; 95% CI: 1.05-1.12) and dialysis initiated after ECMO (HR: 3.4; 95% CI: 1.1-10.8) were independently associated with higher in-hospital mortality and mechanical ventilation (MV) duration before ECMO was not (HR: 1.18; 95% CI: 0.71-2.09). PACS-related symptoms were reported by two-thirds and half of patients at 30- and 90-days post-discharge, respectively. The median EQ-5D score was 0.85 (0.70-1.00) and 0.77 (0.66-1.00) at 30 and 90 days. Of the 15 responders, all previously working patients, except one, have returned to work at 90 days. In conclusion, in-hospital mortality in a large Latin American cohort was comparable to the Global extracorporeal life support organization registry. © 2023 Lippincott Williams and Wilkins. All rights reserved.