J Cardiothorac Vasc Anesth. 2021 Nov 12:S1053-0770(21)00971-X. doi: 10.1053/j.jvca.2021.11.006. Online ahead of print.
OBJECTIVE: To analyze the survival rates of patients with COVID-19 supported with extracorporeal membrane oxygenation (ECMO) and compare the survival rates of patients with COVID-19 supported with ECMO to patients with influenza supported with ECMO.
DESIGN: A systematic review and meta-analysis to assess the impact of ECMO as supportive therapy of COVID-19.
SETTING: The authors performed a search through the Cochrane, EMBASE, and MEDLINE/PubMed databases from inception to February 19, 2021, for studies reporting hospitalized patients with COVID-19 managed with ECMO.
PARTICIPANTS: A total of 134 studies were selected, including 6 eligible for the comparative meta-analysis of COVID-19 versus influenza.
INTERVENTIONS: The authors pooled the risk ratio and random effects model.
MEASUREMENTS AND MAIN RESULTS: The primary endpoint was the overall mortality of patients with COVID-19 receiving ECMO. Of the total number of 58,472 patients with COVID-19 reported, ECMO was used in 4,044 patients. The analysis suggested an overall in-hospital mortality of 39% (95% CI 0.34-0.43). In the comparative analysis, patients with COVID-19 on ECMO had a higher risk ratio (RR) for mortality when compared to influenza patients on ECMO: 72/164 (44%) v 71/186 (38%) RR 1.34; 95% CI 1.05-1.71; p = 0.03.
CONCLUSIONS: ECMO could be beneficial in patients with COVID-19, according to the authors' meta-analysis. The reported mortality rate was 39%. This systematic analysis can provide clinical advice in the current era and ongoing pandemic.