OUTCOMES OF WHITE VS MINORITY PATIENTS WITH COVID-19 WITH ARDS TREATED WITH ECMO

Abstract

TOPIC: Chest Infections TYPE: Original Investigations PURPOSE: Black and Hispanic patients are reported to have higher mortality rates associated with COVID-19 than White patients. There is a paucity of data exploring the effects of extracorporeal membrane oxygenation (ECMO) in COVID-19 patients in respect to race. This study examines differences in outcome between White and Minority COVID-19 patients treated with ECMO in a community hospital. METHODS: This is a retrospective observational study of all patients with acute respiratory distress syndrome (ARDS) secondary to COVID-19 who were treated with ECMO at a tertiary cardiovascular care center between March and December 2020. Patients were stratified into two groups: White and Minority patients. The Minority group was composed entirely of Blacks and Hispanics. Patient demographics, hemodynamics, lab values, treatments, outcomes, and complications were recorded. The primary outcome of interest was mortality. The secondary outcome was rate of ECMO-related complications. RESULTS: We identified 23 consecutive COVID-19 patients with ARDS treated with ECMO, of which 7 (30.5%) were White and 16 (69.5%) were Minorities. 6 White and 13 Minority patients were treated with veno-venous ECMO, with the remaining patients in each group treated with veno-arterial ECMO. There was no significant difference in baseline demographics between groups. Minority patients were found to have a lower mortality rate than White patients (62.5% vs 85.7%, p<0.001). There was no significant difference between groups in the rate of ECMO-related complications, including pneumothorax (p=0.276), hospital-acquired infection (p=0.105), circuit clots (p=0.301), deep vein thrombosis (p=0.243), and major bleeding requiring transfusion (p=0.301). CONCLUSIONS: In our small study, Minority patients appear to have a lower mortality rate in comparison to White patients with ARDS secondary to COVID-19 who were treated with ECMO. Limitations of this study include the small sample size and unequal group sizes. CLINICAL IMPLICATIONS: Larger studies are needed to further explore differences in clinical characteristics and outcomes between Minority and White COVID-19 patients treated with ECMO. DISCLOSURES: No relevant relationships by Yingyot Arora, source=Web Response No relevant relationships by robert chait, source=Web Response No relevant relationships by Kai Chen, source=Web Response no disclosure on file for Cristiano Faber;no disclosure on file for Waqas Ghumman;No relevant relationships by Can Jones, source=Web Response No relevant relationships by Sajid Mirza, source=Web Response No relevant relationships by Renuka Reddy, source=Web Response No relevant relationships by Claudia Tejera Quesada, source=Web Response