tetano
Editor, Senior Moderator
Am J Crit Care
. 2025 Mar 1;34(2):104-110.
doi: 10.4037/ajcc2025524. Extracorporeal Membrane Oxygenation Outcomes: COVID-19 Pneumonia vs Non-COVID-19 Pneumonia
Francisco J Gallegos-Koyner[SUP] 1 [/SUP], Nelson I Barrera[SUP] 2 [/SUP], Adisalem M Teferi[SUP] 3 [/SUP], Katerina Jou[SUP] 4 [/SUP], Roberto C Cerrud-Rodriguez[SUP] 5 [/SUP], David H Chong[SUP] 6 [/SUP]
Affiliations
Background: COVID-19 can cause severe acute respiratory distress syndrome or myocardial dysfunction requiring extracorporeal membrane oxygenation (ECMO). Whether comorbidities or sociodemographic factors influence outcomes in these patients is unclear.
Methods: Adult patients from the National Inpatient Sample dataset with COVID-19 pneumonia or non-COVID-19 pneumonia who underwent ECMO between 2016 and 2021 were included. Cohorts were matched in a 1:5 ratio using propensity scores. The primary outcome of interest was inpatient mortality; secondary outcomes included length of stay, total hospitalization costs, need for dialysis, rate of vascular complications, and discharge disposition.
Results: Weighted patient groups (COVID-19 pneumonia, 5680 patients; non-COVID-19 pneumonia, 430 patients) were identified. Mean (SD) age was 46.0 (11.2) years in the COVID-19 group, 45.1 (12.5) years in the non-COVID-19 group. After matching, unweighted groups (COVID-19 pneumonia, 1136 patients; non-COVID-19 pneumonia, 86 patients) were compared. Patients with COVID-19 pneumonia had higher mortality risk (odds ratio [OR], 1.98; 95% CI, 1.11-3.53; P = .02), longer stays (38.0 vs 28.5 days, P < .001), higher costs ($1 278 270 vs $967 866, P = .002), and less likelihood of discharge home (OR, 0.42; 95% CI, 0.21-0.85; P = .02) than patients with non-COVID-19 pneumonia. Vascular complication rate (OR, 0.77; 95% CI, 0.27-2.26; P = .64) and need for dialysis (OR, 1.01; 95% CI, 0.49-2.08; P = .97) did not differ between groups.
Conclusions: Among patients undergoing ECMO, those with COVID-19 pneumonia had worse outcomes than those with non-COVID-19 pneumonia after adjustment for sociodemographic factors and comorbidities.
. 2025 Mar 1;34(2):104-110.
doi: 10.4037/ajcc2025524. Extracorporeal Membrane Oxygenation Outcomes: COVID-19 Pneumonia vs Non-COVID-19 Pneumonia
Francisco J Gallegos-Koyner[SUP] 1 [/SUP], Nelson I Barrera[SUP] 2 [/SUP], Adisalem M Teferi[SUP] 3 [/SUP], Katerina Jou[SUP] 4 [/SUP], Roberto C Cerrud-Rodriguez[SUP] 5 [/SUP], David H Chong[SUP] 6 [/SUP]
Affiliations
- PMID: 40021357
- DOI: 10.4037/ajcc2025524
Background: COVID-19 can cause severe acute respiratory distress syndrome or myocardial dysfunction requiring extracorporeal membrane oxygenation (ECMO). Whether comorbidities or sociodemographic factors influence outcomes in these patients is unclear.
Methods: Adult patients from the National Inpatient Sample dataset with COVID-19 pneumonia or non-COVID-19 pneumonia who underwent ECMO between 2016 and 2021 were included. Cohorts were matched in a 1:5 ratio using propensity scores. The primary outcome of interest was inpatient mortality; secondary outcomes included length of stay, total hospitalization costs, need for dialysis, rate of vascular complications, and discharge disposition.
Results: Weighted patient groups (COVID-19 pneumonia, 5680 patients; non-COVID-19 pneumonia, 430 patients) were identified. Mean (SD) age was 46.0 (11.2) years in the COVID-19 group, 45.1 (12.5) years in the non-COVID-19 group. After matching, unweighted groups (COVID-19 pneumonia, 1136 patients; non-COVID-19 pneumonia, 86 patients) were compared. Patients with COVID-19 pneumonia had higher mortality risk (odds ratio [OR], 1.98; 95% CI, 1.11-3.53; P = .02), longer stays (38.0 vs 28.5 days, P < .001), higher costs ($1 278 270 vs $967 866, P = .002), and less likelihood of discharge home (OR, 0.42; 95% CI, 0.21-0.85; P = .02) than patients with non-COVID-19 pneumonia. Vascular complication rate (OR, 0.77; 95% CI, 0.27-2.26; P = .64) and need for dialysis (OR, 1.01; 95% CI, 0.49-2.08; P = .97) did not differ between groups.
Conclusions: Among patients undergoing ECMO, those with COVID-19 pneumonia had worse outcomes than those with non-COVID-19 pneumonia after adjustment for sociodemographic factors and comorbidities.