One-Year Mental and Physical Health Assessment in Survivors after Extracorporeal Membrane Oxygenation for COVID-19–related Acute Respiratory Distress Syndrome

Abstract

Rationale Long-term outcomes of patients with coronavirus disease (COVID-19)–related acute respiratory distress syndrome treated with extracorporeal membrane oxygenation (ECMO) are unknown. Objectives To assess physical examination, pulmonary function tests, anxiety, depression, post-traumatic stress disorder and quality of life at 6 and 12 months after ECMO onset. Methods Multicenter, prospective study in patients who received ECMO for COVID-19 acute respiratory distress syndrome from March to June 2020 and survived hospital discharge. Measurements and Main Results Of 80 eligible patients, 62 were enrolled in seven French ICUs. ECMO and invasive mechanical ventilation duration were 18 (11–25) and 36 (27–62) days, respectively. All were alive, but only 19/50 (38%) returned to work and 13/42 (31%) had recovered a normal sex drive at 1 year. Pulmonary function tests were almost normal at 6 months, except for D l CO , which was still impaired at 12 months. Mental health, role-emotional, and role-physical were the most impaired domain compared with patients receiving ECMO who did not have COVID-19. One year after ICU admission, 19/43 (44%) patients had significant anxiety, 18/43 (42%) had depression symptoms, and 21/50 (42%) were at risk for post-traumatic stress disorders. Conclusions Despite the partial recovery of the lung function tests at 1 year, the physical and psychological function of this population remains impaired. Based on the comparison with long-term follow-up of patients receiving ECMO who did not have COVID-19, poor mental and physical health may be more related to COVID-19 than to ECMO in itself, although this needs confirmation.

Neurological complications of critically ill COVID-19 patients

“…The effects of this may be further compounded by postacute sequelae of COVID-19 (PASC) and so the rehabilitation needs of these patients may be significant [40 ▪ ,41 ▪ ]. Of note, severe patients requiring ECMO support may be at high risk of persistent physical and psychological disability at 1 year [42 ▪ ]. Critical Care Recovery clinics with in-person and telehealth options have become valuable resources for ICU survivors and their families.…”

What’s new in adult extracorporeal membrane oxygenation in 2022–2023? Insights from the EuroELSO congress 2023

“…Chommeloux et al also made a noteworthy contribution by providing granular data on 1-year multidimensional outcomes for survivors of COVID-19-related ARDS treated with ECMO. 7 This prospective multicenter study highlighted that the 62 survivors of COVID-19 ECMO were relatively young (with a mean age of 47 years) and had limited comorbidities. A majority had been employed full-time before contracting COVID-19.…”

Association of obesity paradox with prognosis of veno‐venous‐extracorporeal membrane oxygenation in patients with coronavirus disease 2019

“…The included patients were 57 [51-61] (median [interquartile range]) years old, 17 (74%) were male, BMI was 28. 7 [26.5-36.2] kg/m 2 , SOFA score was 10 [8][9][10][11][12], APACHE score was 22 [19][20][21][22][23][24][25][26], Murray score was 3.3 [3.0-3.5], and RESP score was 2 [1][2][3][4]. Remdesivir, dexamethasone, unfractionated heparin, and supine therapy were administered to 14 (61%), 18 (78%), 23 (10%), and 10 (41.6%) patients, respectively.…”