In-hospital and Post-discharge Status in COVID-19 Patients With Acute Respiratory Failure Supported With Extracorporeal Membrane Oxygenation

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Citações na Scopus
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Tipo de produção
article
Data de publicação
2023
Título da Revista
ISSN da Revista
Título do Volume
Editora
LIPPINCOTT WILLIAMS & WILKINS
Autores
FERNANDES, Henrique Mateus
FRANCI, Andre
ROSARIO, Andre Loureiro
SARETTA, Roberta
JR, Laerte Patore
MORAES, Juliana Gil
MOURAO, Matheus Moraes
COSTA, Livia do Valle
Citação
ASAIO JOURNAL, v.69, n.5, p.E181-E187, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Few data from Latin American centers on clinical outcomes in coronavirus disease 2019 (COVID-19) patients with acute respiratory distress syndrome who required extracorporeal membrane oxygenation (ECMO) are published. Moreover, clinical and functional status after hospital discharge remains poorly explored in these patients. We evaluated in-hospital outcomes of severe COVID-19 patients who received ECMO support in two Brazilian hospitals. In one-third of the survivors, post-acute COVID-19 syndrome (PACS), quality of life, anxiety, depression, and return to work were evaluated. Eighty-five patients were included and in-hospital mortality was 47%. Age >65 years (HR: 4.8; 95% confidence interval [CI]: 1.4-16.4), diabetes (HR: 6.0; 95% CI: 1.8-19.6), ECMO support duration (HR: 1.08; 95% CI: 1.05-1.12) and dialysis initiated after ECMO (HR: 3.4; 95% CI: 1.1-10.8) were independently associated with higher in-hospital mortality and mechanical ventilation (MV) duration before ECMO was not (HR: 1.18; 95% CI: 0.71-2.09). PACS-related symptoms were reported by two-thirds and half of patients at 30- and 90-days post-discharge, respectively. The median EQ-5D score was 0.85 (0.70-1.00) and 0.77 (0.66-1.00) at 30 and 90 days. Of the 15 responders, all previously working patients, except one, have returned to work at 90 days. In conclusion, in-hospital mortality in a large Latin American cohort was comparable to the Global extracorporeal life support organization registry.
Palavras-chave
acute respiratory distress syndrome, COVID-19, critical care, extracorporeal membrane oxygenation, post-acute COVID-19 syndrome
Referências
  1. Arroll B, 2010, ANN FAM MED, V8, P348, DOI 10.1370/afm.1139
  2. Badulak J, 2021, ASAIO J, V67, P485, DOI 10.1097/MAT.0000000000001422
  3. Barbaro RP, 2020, LANCET, V396, P1071, DOI 10.1016/S0140-6736(20)32008-0
  4. Combes A, 2018, NEW ENGL J MED, V378, P1965, DOI 10.1056/NEJMoa1800385
  5. Diaz RA, 2021, AM J RESP CRIT CARE, V204, P34, DOI 10.1164/rccm.202011-4166OC
  6. Extracorporeal Life Support Organization (ELSO), US
  7. Fernandes J, 2021, ACTA MEDICA PORT, V34, P601, DOI 10.20344/amp.16277
  8. Goligher EC, 2018, JAMA-J AM MED ASSOC, V320, P2251, DOI 10.1001/jama.2018.14276
  9. Grasselli G, 2019, ANESTHESIOLOGY, V130, P572, DOI 10.1097/ALN.0000000000002624
  10. Henry BM, 2020, J CRIT CARE, V58, P27, DOI 10.1016/j.jcrc.2020.03.011
  11. Hermann M, 2022, ANN INTENSIVE CARE, V12, DOI 10.1186/s13613-022-00980-3
  12. Hodgson CL, 2012, CRIT CARE, V16, DOI 10.1186/cc11811
  13. Karagiannidis C, 2021, AM J RESP CRIT CARE, V204, P991, DOI 10.1164/rccm.202105-1145LE
  14. Kroenke K, 2003, MED CARE, V41, P1284, DOI 10.1097/01.MLR.0000093487.78664.3C
  15. Kurniawati ER, 2021, QUAL LIFE RES, V30, P2123, DOI 10.1007/s11136-021-02834-0
  16. Masur J, 2020, AM J NEURORADIOL, V41, P2009, DOI 10.3174/ajnr.A6728
  17. McPeake J, 2021, BMJ OPEN RESPIR RES, V8, DOI 10.1136/bmjresp-2021-001080
  18. Menezes RD, 2015, QUAL LIFE RES, V24, P2761, DOI 10.1007/s11136-015-0994-7
  19. Munshi L, 2019, LANCET RESP MED, V7, P163, DOI 10.1016/S2213-2600(18)30452-1
  20. Olivier PY, 2021, CRIT CARE, V25, DOI 10.1186/s13054-021-03800-5
  21. Peek GJ, 2009, LANCET, V374, P1351, DOI 10.1016/S0140-6736(09)61069-2
  22. Rajajee Venkatakrishna, 2021, Crit Care Explor, V3, pe0537, DOI 10.1097/CCE.0000000000000537
  23. Ramanathan K, 2021, CRIT CARE, V25, DOI 10.1186/s13054-021-03634-1
  24. Rilinger J, 2021, CRIT CARE, V25, DOI 10.1186/s13054-021-03821-0
  25. Schmidt M, 2014, AM J RESP CRIT CARE, V189, P1374, DOI 10.1164/rccm.201311-2023OC
  26. Skapinakis Petros, 2007, Evid Based Med, V12, P149, DOI 10.1136/ebm.12.5.149
  27. Tzotzos SJ, 2020, CRIT CARE, V24, DOI 10.1186/s13054-020-03240-7
  28. Usman AA, 2020, J CARDIOTHOR VASC AN, V34, P3006, DOI 10.1053/j.jvca.2020.07.063
  29. Wang ZY, 2017, CHINESE MED J-PEKING, V130, P1161, DOI 10.4103/0366-6999.205847
  30. Williamson EJ, 2020, NATURE, V584, P430, DOI 10.1038/s41586-020-2521-4
  31. World Health Organization, 2022, TRACK SARS COV 2 VAR