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

J Card Surg. 2020 Jul;35(7):1410-1413. doi: 10.1111/jocs.14583. Epub 2020 Apr 25.


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.

Keywords: COVID-19; ECMO; cardiogenic shock; coronavirus.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • COVID-19
  • Cause of Death
  • Cohort Studies
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / therapy*
  • Critical Illness / mortality
  • Critical Illness / therapy*
  • Extracorporeal Membrane Oxygenation / methods*
  • Extracorporeal Membrane Oxygenation / mortality
  • Female
  • Follow-Up Studies
  • Hospital Mortality / trends
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / therapy*
  • Respiratory Distress Syndrome / mortality
  • Respiratory Distress Syndrome / therapy*
  • Respiratory Distress Syndrome / virology
  • Retrospective Studies
  • Risk Assessment
  • Treatment Outcome
  • United States