Patient outcomes following extracorporeal membrane oxygenation support for severe COVID-19 acute respiratory distress syndrome.

BACKGROUND

Although patients treated with extracorporeal membrane oxygenation (ECMO) can have reduced long-term lung function, impaired quality of life, and high rates of posttraumatic stress disorder, data on patients with severe COVID-19 requiring ECMO are limited. We undertook a prospective study of our post-COVID ECMO population to assess long-term lung function and quality of life.

METHODS

For patients with COVID who required ECMO support, survival, pulmonary function, spirometry, arterial blood gas, and patient quality of life were assessed.

RESULTS

Twelve patients completed follow-up at a median of 674.5 days. Pulmonary function testing, reported as median percentage of predicted, was as follows: forced vital capacity (FVC), 73.2% (59.8-82); forced expiratory volume over 1 second (FEV1), 72.3% (67.1-88.3); FEV1/FVC, 110% (100-113.1); total lung capacity, 59.3% (50.6-76.7); vital capacity, 75% (57.5-85.3); and diffusing capacity of the lungs for carbon monoxide, 84.5% (71.9-87.4). Arterial blood gas at follow up was pH 7.41 (7.41-7.43); partial pressure of carbon dioxide, 40 mm Hg (39-42); partial pressure of oxygen, 81 mm Hg (76-83); and arterial oxygen saturation, 96% (95-96). The median Short-Form Kansas City Cardiomyopathy Questionnaire overall summary score was 88.8 (72.1-94.8). The Rand Short Form 36 scores were markedly reduced.

CONCLUSION

These findings suggest that patients who required ECMO for COVID-related acute respiratory distress syndrome achieved improvement in objective lung function over time, despite persistent functional limitations. Patients also reported decreased self-reported quality of life.