Extracorporeal membrane oxygenation (ECMO) in patients with COVID-19: a rapid systematic review of case studies

B.-S. Hu, M.-Z Hu, L.-X. Jiang, J. Yu, Y. Chang, Y. Cao, Z.-P. Dai

Department of Anesthesiology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China. zpdai@wnmc.edu.cn

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• Infectious Diseases

OBJECTIVE: COVID-19 can cause severe acute respiratory distress syndrome (ARDS). Extracorporeal membrane oxygenation (ECMO) can support gas exchange in patients failing conventional mechanical ventilation, but its role is still controversial. We performed a rapid systematic review focusing on the use of ECMO in patients with COVID-19.

MATERIALS AND METHODS: PubMed/MEDLINE, Google Scholar, Embase, the Cochrane Library, EBSCO and Ovid (updated 30 April 2020) were systematically searched. Case reports/Case series from COVID-19 patients treated with ECMO were included in the study. Three reviewers assessed, selected, and abstracted data from studies. All disparate opinions were resolved through discussion.

RESULTS: We included 13 articles for systematic evaluation, including 10 case reports and 3 case series studies, with a total of 72 patients. We search for the following information: First author of articles; Patient’s location; age; gender; body mass index (BMI); Comorbidities; Time on ECMO; Mode of ECMO; treatments and clinical outcomes. As of all reporting times, our data show that 38 patients (52.8%) have died definitively, 13 patients (18.0%) were still receiving ECMO treatment, 12 patients (16.7%) were alive, 7 patients (9.7%) were recovery and 2 cases (2.8%) remained hospitalized.

CONCLUSIONS: ECMO plays an important role in the stabilization and survival critically ill patients with COVID-19, but the usefulness of ECMO in reducing the mortality of severe ARDS caused by COVID-19 was limited. Therefore, a larger sample size study and a comprehensive analysis of evaluating the medical value of using ECMO on COVID-19 patients are urgently required.

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