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.