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?:abstract
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No study has compared patients with COVID-19 related refractory ARDS requiring Veno-Venous ExtraCorporeal Membrane Oxygenation (V-V ECMO) to a relevant and homogenous control population. We aimed to compare the outcomes, the clinical characteristics and the adverse effects of COVID-19 patients to a retrospective cohort of influenza patients.This retrospective case-control study was conducted in the ICUs of Lille and Rouen University Hospitals between January 2014 and May 2020. Two independent cohorts of patients with ARDS requiring V-V ECMO infected with either COVID-19 (n =30) or influenza (n=22) were compared. A 3-month follow-up was completed for all patients.Median age of COVID-19 and influenza patients was similar (57 vs. 55 years; p=0.62). The 28-day mortality rate did not significantly differ between COVID-19 (43.3%) and influenza patients (50%, p=0.63). There was no significant difference considering the cumulative incidence of ECMO weaning, hospital discharge and 3-month survival. COVID-19 patients had a lower SAPS II score (58 [37-64] vs. 68 [52-83]; p=0.039), a higher Body Mass Index (33 [29-38] vs. 30 [26-34] kg/m; p=0.05), and were cannulated later (median delay between mechanical support and V-V ECMO 6 vs. 3 days, p=0.004) compared to influenza patients. No difference in overall adverse events was observed between COVID-19 and influenza patients (70% vs. 95.5% respectively; p=0.23).Despite differences in clinical presentation before V-V ECMO implantation, 28-day and 3-month mortality rate did not differ between COVID-19 and influenza patients. Considering the lack of specific treatment for COVID-19, V-V ECMO should be considered as a relevant rescue organ support.
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