P89: The Impact of Symptoms Duration and Management of COVID-19 Associated Severe Acute Respiratory Distress Syndrome on the Venovenous Extracorporeal Membrane Oxyanion Outcomes

Abstract

Background: veno-venous extracorporeal membrane oxygenation (V-V ECMO) is well established supportive intervention for patients with coronavirus 2019 severe acute respiratory distress. It is unclear if the duration of symptoms and noninvasive and invasive mechanical ventilation before ECMO might impact the clinical outcomes. Methods: We examined COVID-19 patients supported for severe acute respiratory distress syndrome (ARDS) by V-V ECMO at a quandary care institution. The study period was extended from April 1, 2020, to January 1, 2021. Results: Forty-six patients with confirmed COVID-19 were included in our analysis. The mean age was 44.83 +/- 10.46 years old, and the majority were males (63%). 54.3% of COVID-19 patients supported by V-V ECMO survived hospital discharge. The univariant hazards ratio (HR) showed that the prolonged duration of COVID-19 symptoms before initiating ECMO reduced the chance of hospital discharge (HR = 0.932, 95% CI = 0.878-0.99, p = 0.023). Despite not being statistically significant, the longer the duration of the non-invasive mechanical ventilation, the lower the chance of hospital discharge for ECMO patients (HR = 0.895, 95% CI = 0567-1.415, p = 0.636). However, the use of intravenous steroids led to increased hospital discharge, albeit the result remains statistically insignificant (HR =1.545, 95% CI = 0.621-3.846, p = 0.35). Conclusion: Duration of the COVID-19 symptoms and the extended use of non-invasive mechanical ventilation could be associated with poor outcomes for patients supported by V-V ECMO.