In the last 10 years, severe acute respiratory infection (SARI) was responsible of multiple outbreaks putting a strain on the public health worldwide. Indeed, SARI had a relevant role in the development of pandemic and epidemic with terrible consequences such as the 2009 H1N1 pandemic which led to more than 200.000 respiratory deaths globally. In late December 2019, in Wuhan, Hubei, China, a new respiratory syndrome emerged with clinical signs of viral pneumonia and person-to-person transmission. Tests showed the appearance of a novel coronavirus, namely the 2019 novel coronavirus (COVID-19). Two other strains, the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) have caused severe respiratory illnesses, sometimes fatal. In particular, the mortality rate associated with SARS-CoV and MERS-CoV, was of 10% and 37% respectively. Even though COVID-19 appeared from the first time in China, quickly it spread worldwide and cases have been described in other countries such as Thailand, Japan, South Korea, Germany, Italy, France, Iran, USA and many other countries. An early paper reported 41 patients with laboratory-confirmed COVID-19 infection in Wuhan. The median age of the patients was 49 years and mostly men (73%). Among those, 32% were admitted to the ICU because of the severe hypoxemia. The most associated comorbidities were diabetes (20%), hypertension (15%), and cardiovascular diseases (15%). On admission, 98% of the patients had bilateral multiple lobular and sub-segmental areas of consolidation. Importantly, acute respiratory distress syndrome (ARDS) developed in 29% of the patients, while acute cardiac injury in 12%, and secondary infection in 10%. Invasive mechanical ventilation was required in 10% of those patients, and two of these patients (5%) had refractory hypoxemia and received extracorporeal membrane oxygenation (ECMO). In a later retrospective report by Wang and collaborators, clinical characteristics of 138 patients with COVID-19 infection were described. ICU admission was required in 26.1% of the patients for acute respiratory distress syndrome (61.1%), arrhythmia (44.4%), and shock (30.6%). ECMO support was needed in 11% of the patients admitted to the ICU. During the period of follow-up, overall mortality was 4.3%. The use of ECMO in COVID-19 infection is increasing due to the high transmission rate of the infection and the respiratory-related mortality. Therefore, the investigators believe that ECMO in case of severe interstitial pneumonia caused by COVID could represent a valid solution in order to avoid lung injuries related to prolonged treatment with non-invasive and invasive mechanical ventilation. In addition, ECMO could have a role for the systemic complications such as septic and cardiogenic shock as well myocarditis scenarios. Potential clinical effects and outcomes of the ECMO support in the novel coronavirus pandemic will be recorded and analyzed in our project. The researchers hypothesize that a significant percentage of patients with COVID-19 infection will require the utilize of ECMO for refactory hypoxemia, cardiogenic shock or septic shock. This study seeks to prove this hypothesis by conducting an observational retrospective/prospective study of patients in the ICU who underwent ECMO support and describe clinical features, severity of pulmonary dysfunction and risk factors of COVID-patients who need ECMO support, the incidence of ECMO use, ECMO technical characteristics, duration of ECMO, complications and outcomes of COVID-patients requiring ECMO support.
Inclusion Criteria:
- Laboratory-confirmed COVID-19 infection by real-time PCR (polymerase chain reaction)
- ECMO for treatment severe lung disease COVID-19 related
Exclusion Criteria:
- Patients treated with ECMO for other concomitant causes.
Universitätskliniken Innsbruck
Innsbruck, Austria
Landesklinikum Sankt Polten
St.Pölten, Austria
Medical University of Vienna
Vienna, Austria
Onze Lieve Vrouwziekenhuis Aalst
Aalst, Belgium
University Hospital, Antwerp
Antwerp, Belgium
Centre Hospitalier Universitaire Saint Pierre
Brussels, Belgium
Chirec
Brussels, Belgium
Erasme University Hospital
Brussel, Belgium
Universitair Ziekenhuis Brussel
Brussel, Belgium
Hôpital Civil Marie Curie de Charleroi
Charleroi, Belgium
University Hospital, Ghent
Ghent, Belgium
La Louvière Hopital
La Louvière, Belgium
Universitaire Ziekenhuizen Leuven
Leuven, Belgium
CHU de Liege
Liège, Belgium
Charles University, Czech Republic
Praha, Czechia
General University Hospital, Prague
Praha, Czechia
Copenhagen University Hospital at Herlev
Copenhagen, Denmark
University Hospital, Bordeaux
Bourdeaux, France
Hospices Civils de Lyon
Lyon, France
University Hospital, Montpellier
Montpellier, France
Henri Mondor University Hospital
Paris, France
Paris South University Hospitals
Paris, France
Pitié-Salpêtrière Hospital
Paris, France
Rennes University Hospital
Rennes, France
University Hospital, Aachen
Aachen, Germany
German Heart Center
Berlin, Germany
Universitätsklinikum Düsseldorf
Düsseldorf, Germany
Children's Medical Hospital, University of Essen, Essen, Germany
Essen, Germany
University Hospital, Essen
Essen, Germany
University Heart Center Freiburg - Bad Krozingen
Freiburg, Germany
Hannover Medical School
Hannover, Germany
Klinikum Kassel
Kassel, Germany
Universitätsklinikum Köln
Köln, Germany
Heart Center Leipzig - University Hospital
Leipzig, Germany
Klinikum Nürnberg
Nürnberg, Germany
University Hospital Regensburg
Regensburg, Germany
University Hospital Tuebingen
Tuebingen, Germany
University Hospital, Alexandroupolis
Alexandroupolis, Greece
Heim Pal Children's Hospital
Budapest, Hungary
ECMO Centers Israel
Jerusalem, Israel
San Giorgio Clinic
Alessandria, Italy
Ospedali Riuniti Ancona
Ancona, Italy
Papa Giovanni XXIII Hospital
Bergamo, Italy
St. Orsola Hospital
Bologna, Italy
Azienda Ospedaliera Spedali Civili di Brescia
Brescia, Italy
Ospedale Maurizio Bufalini
Cesena, Italy
Gaslini Children's Hospital
Genua, Italy
G. Pasquinucci Heart Hospital, Massa
Massa, Italy
Policlinico Hospital Milan
Milano, Italy
Niguarda Hospital
Milan, Italy
Ospedale San Donato
Milan, Italy
San Raffaele University Hospital, Italy
Milan, Italy
San Gerardo Hospital
Monza, Italy
IRCCS Policlinico S. Matteo
Pavia, Italy
GVM Care & Research
Puglia, Italy
Bambino Gesù Hospital and Research Institute
Roma, Italy
San Camillo Hospital, Rome
Roma, Italy
A.O.U. Città della Salute e della Scienza - Molinette Hospital
Turin, Italy
Mauriziano Umberto I Hospital
Turin, Italy
Ospedale S. Giovanni Bosco
Turin, Italy
University Hospital, Udine, Italy
Udine, Italy
Ospedale dell'Angelo, Venezia-Mestre
Venice, Italy
Ospedale San Bortolo di Vicenza
Vicenza, Italy
Vilnius University Hospital Santaros Klinikos
Vilnius, Lithuania
University of Groningen
Groningen, Netherlands
Leiden University Medical Center
Leiden, Netherlands
Maastricht University Medical Center
Maastricht, Netherlands
Erasmus Medical Center
Rotterdam, Netherlands
UMC Utrecht
Utrecht, Netherlands
Medical University of Warsaw
Warsaw, Poland
Hospital Sao Joao
Porto, Portugal
Chelyabinsk Regional Clinical Hospital
Chelyabinsk, Russian Federation
City Hospital No 41, Ekaterinburg, Russia
Ekaterinburg, Russian Federation
Kemerovo Regional Clinical Cardiological Center named after academician L.S. Barbarash
Kemerovo, Russian Federation
Krasnodar Regional Hospital no 1
Krasnodar, Russian Federation
City Clinical Hospital No. 67, Moscow, Russia
Moscow, Russian Federation
Novosibirsk City Hospital #2
Novosibirsk, Russian Federation
City Hospital No 40, Saint Petersburg, Russia
Saint Petersburg, Russian Federation
Hospital Sant Joan de Deu
Barcelona, Spain
Hospital Vall d'Hebron
Barcelona, Spain
Hospital Universitario Ramon y Cajal
Madrid, Spain
Hospital Miguel Servet
Zaragoza, Spain
Lund University Hospital
Lund, Sweden
Karolinska University Hospital
Stockholm, Sweden
University Hospital, Basel, Switzerland
Basel, Switzerland
University of Bern
Bern, Switzerland
University Hospital, Geneva
Geneva, Switzerland
University of Lausanne Hospitals
Lausanne, Switzerland
Cardiocentro Ticino
Lugano, Switzerland
Klinik Hirslanden, Zurich
Zürich, Switzerland
University of Zurich
Zürich, Switzerland
Royal Brompton & Harefield NHS Foundation Trust
Brompton, United Kingdom
Paediatric Intensive Care Glasgow
Glasgow, United Kingdom
Leicester Children's Hospital
Leicester, United Kingdom
Great Ormond Street Hospital for Children NHS Foundation Trust
London, United Kingdom
Guy's and St Thomas' NHS Foundation Trust
London, United Kingdom
Newcastle-upon-Tyne Hospitals NHS Trust
Newcastle Upon Tyne, United Kingdom
Lorusso, Prof. Dr.
+ 31(0) 433877095
roberto.lorussobs@gmail.com
Lorusso, Prof. Dr., Principal Investigator
Maastricht University Hospital