The role of extracorporeal life support for patients with COVID‐19: Preliminary results from a statewide experience

Sultan, Ibrahim; Habertheuer, Andreas; Usman, Asad A.; Kilic, Arman; Gnall, Eric; Friscia, Michael E.; Zubkus, Dmitriy; Hirose, Hitoshi; Sanchez, Pablo; Okusanya, Olugbenga; Szeto, Wilson Y.; Gutsche, Jacob

OBJECTIVE: There is a paucity of clinical data on critically ill patients with COVID‐19 requiring extracorporeal life support. METHODS: A statewide multi‐institutional collaborative for COVID‐19 patients was utilized to obtain clinical data on the first 10 critically ill COVID‐19 patients who required extracorporeal membrane oxygenation (ECMO). RESULTS: Of the first 10 patients that required ECMO for COVID‐19, the age ranged from 31 to 62 years with the majority (70%) being men. Seven (70%) had comorbidities. The majority (80%) of patients had known sick contact and exposure to COVID‐19 positive patients or traveled to pandemic areas inside the United States within the 2 weeks before symptom onset. None of the patients were healthcare workers. The most common symptoms leading to the presentation were high fever ≥103°F (90%), cough (80%) and dyspnea (70%), followed by fatigue and gastrointestinal symptoms (both 30%), myalgia, loss of taste, pleuritic chest pain, and confusion (all 10%). All patients had bilateral infiltrates on chest X‐rays suggestive of interstitial viral pneumonia. All patients were cannulated in the venovenous configuration. Two (20%) patients were successfully liberated from ECMO support after 7 and 10 days, respectively, and one (10%) patient is currently on a weaning course. One patient (10%) died after 9 days on ECMO from multiorgan dysfunction. CONCLUSIONS: These preliminary multi‐institutional data from a statewide collaborative offer insight into the clinical characteristics of the first 10 patients requiring ECMO for COVID‐19 and their initial clinical course. Greater morbidity and mortality is likely to be seen in these critically ill patients with longer follow‐up.