Post COVID symptom burden in patients supported with extracorporeal membrane oxygenation: A prospective 2-year follow-up analysis.

Abstract

Objectives: A systematic characterization of the long-term sequelae after the severest form of COVID-19 requiring ECMO-therapy is lacking. Here, we present 2-year follow-up data of COVID-19 ECMO survivors, and analyze the cardiopulmonary, neurocognitive, psychological, and functional status, plus health-related quality of life (HRQL).

Methods: From 04/2020 to 09/2021, 60 COVID patients were supported with ECMO. Survival to discharge was 40.0% (n = 24), and 6-month survival was 33.3% (n = 20). Follow-ups were performed via phone and mail using validated tools. Six-month outcomes have been published before.

Results: At 2 years, 20 patients were alive. N = 19 agreed to participate in this study (median age 57.0 (45.0-63.0) years, 21.1% female). The cardiopulmonary status was satisfactory (78.9% in NYHA level I-II). Altogether, 84.2% were vastly independent in daily life. However, 47.4% still showed cognitive impairment, 21.1% moderate, 15.8% severe depression, and 15.8% posttraumatic stress disorder symptoms. HRQL subscale results were similar to 6 months, but patients self-rated their overall health significantly better (70.0% (50.0%-80.0%) vs 50.0% (30.0%-80.0%), p = 0.04). The number of patients working was increasing. Social life remained markedly affected.

Conclusions: Two-year outcomes in COVID-19 ECMO patients were stable to improving as compared to 6-month results. However, long-term impairments affected all aspects of life. Long COVID specifically, and post ECMO sequelae in general need to be characterized further to enable maximum recovery.