Functional outcomes among the survivors of veno-venous extracorporeal membrane oxygenation during the COVID-19 pandemic: a historical cohort study.

Abstract

Purpose: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is increasingly being used in patients with respiratory failure. The goal of this study was to characterize postdischarge psychological and functional outcomes of this patient population.

Methods: We conducted a historical cohort study of survivors who required VV-ECMO during the COVID-19 pandemic. Using telephone interviews, we assessed the following domains: disability (using the World Health Organization Disability Schedule [WHODAS 2.0] and modified Rankin Scale [mRS]), health-related quality of life (using the European Quality of Life 5 Dimensions 5 Level tool), cognition (using the telephone Montreal Cognitive Assessment tool), depression (using the Patient Health Questionnaire-9), and posttraumatic stress disorder symptoms (using the Impact of Event Scale-6). We used descriptive statistics to analyze our results.

Results: Twenty-six participants with a median [interquartile range (IQR)] age of 47 [42-59] yr and 6 (23%) of whom were female were evaluated at a median [IQR] of 22 [17-23] months after ECMO separation. Twenty-two (85%) had a diagnosis of COVID-19. The median [IQR] WHODAS 2.0 score was 26 [15-30] with the highest degree of disability in the mobility and participation domains. Of the 24 participants who were employed full-time, 12 (50%) were able to work in the same capacity. Of the 25 respondents who were living independently at baseline, 22 (88%) maintained complete independence for their activities of daily living (mRS < 3), one (4%) described persistent functional limitations (mRS = 3), and two (8%) required constant care (mRS = 4 or 5). Thirteen (52%) and nine (38%) reported at least moderate pain or anxiety, respectively. Ten (40%) and seven (28%) participants screened positive for symptoms of depression or posttraumatic stress disorder, respectively.

Conclusions: Patients who required VV-ECMO experienced significant functional disability, pain, cognitive challenges, mental health problems, and lower quality of life approximately two years after discharge.