Piero, Maria Elena De and Mariani, Silvia and Bussel, Bas C. T. van and Jarczak, Dominik and Krenner, Niklas and Sota, Enrique Perez de la and Silva, Pedro E. and Roemmer, Magdalena and Kowalewski, Mariusz and Carelli, Simone and Broman, Lars Mikael and Vuylsteke, Alain and Fortuna, Philip and Alessandri, Francesco and Martucci, Gennaro and Patel, Brijesh and Lotz, Gosta and Boeken, Udo and Maier, Sven and Filip, Bursa and Meyns, Bart and Haenggi, Matthias and Puss, Severin and Schellongowski, Peter and Kirali, Kaan and Bolotin, Gil and Barrett, Nicholas and Riera, Jordi and Mueller, Thomas and Belohlavek, Jan and Lorusso, Roberto (2025) In-hospital outcomes and 6-month follow-up results of patients supported with extracorporeal membrane oxygenation for COVID-19 from the second wave to the end of the pandemic (EuroECMO-COVID): a prospective, international, multicentre, observational study. LANCET RESPIRATORY MEDICINE, 13 (4). pp. 307-317. ISSN 2213-2600,
Full text not available from this repository. (Request a copy)Abstract
Background Extracorporeal membrane oxygenation (ECMO) for COVID-19 was thoroughly assessed during the first pandemic wave, but data on subsequent waves are limited. We aimed to investigate in-hospital and 6-month survival of patients with COVID-19 supported with ECMO from the second pandemic wave (Sept 15, 2020) until the end of the pandemic (March 21, 2023, announced by WHO). Methods EuroECMO-COVID is a prospective, observational study including adults (aged >= 16 years) requiring ECMO respiratory support for COVID-19 from 98 centres in 21 countries. We compared patient characteristics and outcomes between in-hospital survivors and non-survivors. Mixed-effects multivariable logistic regressions were used to investigate factors linked to in-hospital mortality. 6-month survival and overall patient status were determined via patient contact or chart review. This study is registered with ClinicalTrials.gov, NCT04366921, and is complete. Findings We included 3860 patients (2687 [69<middle dot>7%] were male and 1169 [30<middle dot>3%] were female; median age 51 years [SD 11]) from 98 centres in 21 countries. In-hospital mortality was 55<middle dot>9% (n=2158), with 81<middle dot>2% (n=1752) deaths occurring during ECMO support. More non-survivors had diabetes, hypertension, cardiovascular disease, and renal failure, and required more pre-ECMO inotropes and vasopressors compared with survivors. Median support duration was 18 days (IQR 10-31) for both groups. Factors linked to in-hospital mortality included older age, pre-ECMO renal failure, pre-ECMO vasopressors use, longer time from intubation to ECMO initiation, and complications, including neurological events, sepsis, bowel ischaemia, renal failure, and bleeding. Of the 1702 (44<middle dot>1%) in-hospital survivors, 99<middle dot>7% (n=1697) were alive at 6 months follow-up. Many patients at 6 months follow-up had dyspnoea (501 [32<middle dot>0%] of 1568 patients), cardiac (122 [7<middle dot>8%] of 1568 patients), or neurocognitive (168 [10<middle dot>7%] of 1567 patients) symptoms. Interpretation Our data for patients undergoing ECMO support for respiratory distress from the second COVID-19 wave onwards confirmed most findings from the first wave regarding patient characteristics and factors correlated to in-hospital mortality. Nevertheless, in-hospital mortality was higher than during the initial pandemic wave while 6-month post-discharge survival remained favourable (99<middle dot>7%). Persisting post-discharge symptoms confirmed the need for post-ECMO patient follow-up programmes. Funding None. Copyright (c) 2025 Published by Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ORGANIZATION; COHORT; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 24 Mar 2026 06:47 |
| Last Modified: | 24 Mar 2026 06:47 |
| URI: | https://pred.uni-regensburg.de/id/eprint/68076 |
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