Objectives: The role of extracorporeal membrane oxygenation (ECMO) in the management of critically
ill COVID-19 patients remains unclear. Our study aims to analyze the outcomes and
risk factors from patients treated with ECMO.
Methods: This retrospective, single-center study includes seventeen COVID-19 patients treated
with ECMO. Univariate and multivariate parametric survival regression identified predictors
of survival.
Result: Nine patients (53%) were successfully weaned from ECMO and discharged. The incidence
of in-hospital mortality was 47%. In a univariate analysis, only four out of 83 pre-ECMO
variables were significantly different; IL-6, PCT, and NT-proBNP were significantly
higher in non-survivors compared with survivors. The Respiratory Extracorporeal Membrane
Oxygenation Survival Prediction (RESP) score was significantly lower in survivors.
After a multivariate parametric survival regression, IL-6, NT-proBNP and RESP scores
remained significant independent predictors, with hazard ratios (HR) of 1.069 [95%
CI: 0.986–1.160], p = 0.016 1.001 [95% CI: 1.000–1.001], p = 0.012; and 0.843 [95% CI: 0.564–1.260], p = 0.040, respectively. A prediction model consisting of IL-6, NT-proBNP, and RESP
score showed an area under the curve (AUC) of 0.87, with a sensitivity of 87.5% and
specificity of 77.8%, compared with an AUC of 0.79 for the RESP score alone.
Conclusion: The present study suggests that ECMO is a potentially lifesaving treatment for select
critically ill COVID-19 patients. Considering IL-6 and NT-per-BNP, in addition to
the RESP score, may enhance outcome predictions.
