Six-month mortality in patients with COVID-19 and non-COVID-19 viral pneumonitis managed with veno-venous extracorporeal membrane oxygenation.

A significant proportion of patients with COVID-19 develop acute respiratory distress syndrome (ARDS) with high risk of death. The efficacy of veno-venous extra-corporeal membrane oxygenation (VV-ECMO) for COVID-19 on longer term outcomes, unlike in other viral pneumonias, is unknown. In this study we aimed to compare the 6-month mortality of patients receiving VV-ECMO support for COVID-19 with a historical viral ARDS cohort. Fifty-three consecutive patients with COVID-19 ARDS admitted for VV-ECMO to the Royal Brompton Hospital between 17/03/2020 and 30/05/2020 were identified. Mortality, patient characteristics, complications and ECMO parameters were then compared to a historical cohort of patients with non-COVID-19 viral pneumonia. At 6 months survival was significantly higher in the COVID-19 than in the non-COVID-19 viral pneumonia cohort (84.9% vs. 66.0%, p=0.040). Patients with COVID-19 had an increased Murray score (3.50 vs. 3.25, p=0.005), a decreased burden of organ dysfunction (SOFA score (8.76 vs. 10.42, p=0.004), an increased incidence of pulmonary embolism (69.8% vs. 24.5%, p<0.001) and in those who survived to decannulation longer ECMO runs (19 vs. 11 days, p=0.001). Our results suggest that survival in patients supported with EMCO for COVID-19 are at least as good as those treated for non-COVID-19 viral ARDS.