Table 2.
Clinical outcomes of patients with severe acute respiratory distress syndrome associated with refractory COVID-19 who were initiated on venovenous ECMO including use of concurrent therapies and complications related to ECMO
| Survival to discharge from ECMO facility, n (%) | 21/37 (56.8) |
| In-hospital mortality, n (%) | 16/37 (43.2) |
| Death from withdrawal of care on ECMO | 13/37 (35.1) |
| Decannulated from ECMO, n (%) | 24/37 (64.9) |
| Deceased after decannulation, n (%) | 3/24 (12.5) |
| Required tracheostomy | 20/26 (76.9) |
| Median time from intubation to tracheostomy, d (IQR) | 19 (16.5-25.3) |
| Median duration of continuous ventilation, d (IQR) | 35 (20.5-47) |
| Median duration of ECLS, d (IQR) | 17 (10-33.5) |
| Median ICU LOS, d (IQR) | 31 (24-51.5) |
| Median hospital LOS, d (IQR) | 44 (31-62) |
| Concurrent COVID-19 therapy, n (%) | |
| Hydroxychloroquine | 17/37 (45.9) |
| Azithromycin | 20/37 (54.1) |
| Anti-IL-6 receptor monoclonal antibody∗ | 25/37 (67.6) |
| Steroids | 26/37 (70.3) |
| Remdesivir | 20/37 (54.1) |
| Systemic anticoagulation | 37/37 (100) |
| Convalescent plasma | 16/37 (43.2) |
| Concurrent interventions, n (%) | |
| CRRT | 19/37 (51) |
| Chest tubes | 11/37 (30) |
| New brain injury, n (%) | |
| Ischemic | 0/37 (0) |
| Hemorrhagic | 3/37 (8) |
| Coagulopathy (INR >3), n (%) | 0/37 (0) |
| Liver failure (ALT >5 times upper limit), n (%) | 5/37 (14) |
| Cardiogenic shock, n (%) | 2/37 (5) |
| Bacterial pneumonia, n (%) | 7/37 (19) |
| Bloodstream infection, n (%) | 4/37 (11) |
| ECMO complications, n (%) | |
| Bleeding | 12/37 (32) |
| Cannula malposition | 1/37 (3) |
| ECMO circuit | 2/37 (5) |
The total cohort comprised 37 patients; the numerator and denominator (number of eligible patients) for relevant outcomes are listed in the table. In-hospital mortality is calculated from patients who were discharged or died in the hospital. Duration of continuous ventilation, ICU LOS, and hospital LOS calculated from the 21 patients who survived to discharge. Duration of ECLS calculated from the 24 patients weaned to decannulation. ECMO, Extracorporeal membrane oxygenation; IQR, interquartile range; ECLS, extracorporeal life support; ICU, intensive care unit; LOS, length of stay; COVID-19, coronavirus disease 2019; CRRT, continuous renal-replacement therapy; INR, international normalized ratio; ALT, alanine transaminase.
Administered against placebo in a double-blinded fashion.