Symptoms persist long after ECMO for COVID-19, study finds
An analysis of French ICU patients who underwent extracorporeal membrane oxygenation (ECMO) for COVID-19 found that at one year, 44% had significant anxiety, 42% had depression symptoms, 42% were at risk for post-traumatic stress disorder, and only 38% had returned to work.
A recent study reported the long-term outcomes of patients treated with extracorporeal membrane oxygenation (ECMO) for COVID-19.
The multicenter prospective study included 62 patients in seven French ICUs who received ECMO for acute respiratory distress syndrome from COVID-19 in March to June 2020 and survived to hospital discharge. They underwent physical examination, pulmonary function tests, and assessment of anxiety, depression, post-traumatic stress disorders (PTSD), and quality of life at six and 12 months after ECMO onset. Results were published by the American Journal of Respiratory and Critical Care Medicine on Sept. 23.
The patients had a median duration of 18 days on ECMO and 36 days on invasive mechanical ventilation. None of the patients died during follow-up, but only 38% had returned to work and 31% had recovered a normal sex drive at one year. The patients' pulmonary function tests were almost normal at six months, except for diffusing capacity for carbon monoxide, which was still impaired at 12 months. One year after ICU admission, 44% of patients had significant anxiety, 42% had depression symptoms, and 42% were at risk for PTSD.
“Notably, we reported a high prevalence of clinical symptoms of anxiety, depression, and post-traumatic stress, which was significantly higher than less severe patients hospitalized for COVID. These results are important, even if expected with such clinical severity and prolonged ICU stay,” said the study authors, who noted that “psychological sequelae were significantly more frequent than those reported by non-COVID patients treated by ECMO,” indicating that some of the effects may have been due to COVID-19 specifically.
The study was limited by its small size, loss of patients during follow-up, and no baseline data on the psychological measures, the authors noted. They called for “personalized, multi-disciplinary, and prolonged follow-up after hospital discharge of future COVID patients and their families” and studies of long-term outcomes of patients who underwent ECMO later in the pandemic.
