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

Author:

Galas Filomena Regina Barbosa Gomes12,Fernandes Henrique Mateus1,Franci André1ORCID,Rosario André Loureiro1,Saretta Roberta1,Patore Laerte1,Baracioli Luciano Moreira12,Moraes Juliana Gil1,Mourão Matheus Moraes1,Costa Livia do Valle1,Nascimento Teresa Cristina Dias Cunha1,Drager Luciano Ferreira12,Dias Marcia Rodrigues Sundin1,Kalil-Filho Roberto12

Affiliation:

1. Hospital Sírio-Libanês, São Paulo, Brazil

2. Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

Abstract

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.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Biomedical Engineering,General Medicine,Biomaterials,Bioengineering,Biophysics

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