Abstract
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. This retrospective, single-center study includes 17 COVID-19 patients treated with ECMO. Univariate and multivariate parametric survival regression identified predictors of survival. 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 than in survivors. The Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) score was significantly higher 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 = .016 1.001 [95%-CI: 1.000-1.001], P = .012; and .843 [95%-CI: 0.564-1.260], P = .040, respectively. A prediction model comprising IL-6, NT-proBNP, and RESP score showed an area under the curve (AUC) of 0.87, with a sensitivity of 87.5% and 77.8% specificity compared to an AUC of 0.79 for the RESP score alone. The present study suggests that ECMO is a potentially lifesaving treatment for selected critically ill COVID-19 patients. Considering IL-6 and NT-pro-BNP, in addition to the RESP score, may enhance outcome predictions.
Keywords: Acute respiratory distress syndrome; COVID-19; SARS-CoV-2; critical care; extra corporeal membrane oxygenation; risk factors.
【저자키워드】 COVID-19, SARS-CoV-2, Critical care, acute respiratory distress syndrome, Risk factors., extra corporeal membrane oxygenation, 【초록키워드】 Treatment, Respiratory distress syndrome, Risk factors, Critical care, acute respiratory distress syndrome, IL-6, prediction, outcome, risk factor, sensitivity, specificity, extracorporeal membrane oxygenation, survival, Critically ill, Survivors, management, Patient, ECMO, membrane, predictor, incidence, respiratory, NT-proBNP, Critical, in-hospital mortality, COVID-19 patients, retrospective, distress, independent predictors, COVID-19 patient, AUC, critically ill COVID-19 patients, Extracorporeal, respiratory distress, an area, hazard ratio, NT-pro-BNP, RESP Score, single-center study, hazard ratios, Univariate analysis, variable, PCT, non-survivor, ENhance, selected, significantly, include, addition, remained, treated, significantly higher, discharged, patients treated, 【제목키워드】 Mortality, predictor, COVID-19 patient, role, Ill,