ECLS | Extracorporeal Membrane Oxygenation

Registry Dashboard of ECMO-Supported COVID-19 Patient Data

Thank you for helping ELSO disseminate information by entering your experience in the ELSO Registry as soon as ECMO is implanted - before the run is complete. Instructions for entering data in the Registry and COVID-19 addendum can be found on the Data Definitions page.

We recognize you cannot complete and submit the entire ELSO Registry case report form prior to completion of the ECMO run and discharge from the hospital, but we would still like to have the data you know now.

To address concerns about incomplete data we report three nested data sets to accommodate the fact that different patients will be at different stages of care (and thus have more or less incomplete data). Also when considering the data please understand that the data displayed is a real-time data stream and subject to change as more patient information is accrued and as centers update the ELSO Registry Case Report Form and the ELSO COVID-19 addendum.

COVID-19 Cases on ECMO in the ELSO Registry

Total COVID-19 Cases	COVID-19 Confirmed Cases 15,102
Total counts of COVID-19 confirmed patients.

COVID-19 ECMO counts by ELSO Chapter

	Still on ECMO	Still Hospitalized at ELSO Center	Total (n)
All ELSO	560	859	15,164
North America	185	293	9,772
Europe	175	252	3,111
Asia Pacific	32	49	302
Latin America	124	187	989
SWAAC	44	78	990
Reports counts of ECMO-supported suspected or confirmed COVID-19 cases by ELSO Chapter

Filters affect the data shown in the tables below:

Year To Date

All Dates YTD

Patient Age

All Ages Neonatal / Pediatric Adult

Filter

Patients who initiated ECMO at
least 90 days ago

COVID-19
Confirmed
444

COVID-19
In-hospital Mortality
30%

Outcomes

Pre-ECMO Patient Factors

Patient-level summaries of COVID ECMO runs. All categorical variables are given as 'percentage (count)'
	Total	ARDS Cohort
Number cases	444	161
Age(years)
Median(IQR)	10(1,16)	14(2,17)
# observed	444	161
BMI, kg/m2
Median(IQR)	25(17,37)	33(22,42)
# observed	386	144
Sex
Male	49%(217)	50%(80)
Female	51%(227)	50%(81)
# observed	444	161
Race/Ethnicity
Black	21%(92)	16%(25)
White (Non-Hispanic)	37%(165)	38%(61)
Asian	4%(18)	5%(8)
Mid East, N African	2%(11)	5%(8)
Other	2%(11)	2%(4)
Unknown	4%(19)	4%(7)
Multiple	3%(14)	4%(6)
Hispanic	26%(114)	26%(42)
# observed	444	161
Pre-ECMO Comorbidities
No comorbidity	43%(189)	34%(55)
Cancer	3%(12)	2%(4)
Pregnancy	1%(3)	1%(2)
Immunocompromised	7%(30)	6%(10)
Diabetes	9%(38)	12%(20)
Pre-existing heart disease	7%(31)	1%(1)
Pre-existing lung disease	5%(22)	6%(9)
Pre-existing renal insuff.	2%(7)	1%(1)
Frailty	2%(7)	1%(2)
Asthma	14%(61)	18%(29)
BMI $> 30 \mathrm{kg}/\mathrm{m}^2$	33%(145)	50%(80)
Hypertension	7%(29)	12%(19)
# observed	444	161
Acute illness
ARDS	53%(235)	100%(161)
Acute heart failure	20%(87)	4%(6)
Myocarditis	12%(54)	0%(0)
Acute kidney injury	18%(80)	18%(29)
# observed	444	161
Pre-ECMO Cardiac Arrest
Yes	19%(82)	3%(5)
No	81%(361)	97%(156)
# observed	443	161
Pre-ECMO Co-Infection
No Co-infection	53%(234)	50%(81)
Bacterial pneumonia	33%(146)	39%(62)
Co-viral infection	20%(90)	19%(31)
Blood stream infection	14%(61)	16%(26)
Urinary tract infection	5%(23)	10%(16)
# observed	444	161

Pre-ECMO Interventions

Support and therapies. All categorical variables are given as 'percentage (count)'
	PreECLS	PreECLS
Number cases	444	161
Noninvasive ventilation
Noninvasive ventilation prior to intubation	67%(296)	85%(137)
BiPAP	36%(158)	53%(86)
CPAP	10%(46)	12%(19)
HFNC	43%(192)	53%(85)
# observed	444	161
Pre-ECLS intubation (days)
Median(IQR)	0.7(0.2,3.0)	1.4(0.3,4.5)
# observed	374	141
Ventilator mode
Conventional	82%(323)	81%(121)
# observed	394	150
PEEP, cm H2O
Median(IQR)	12.0(8.0,15.0)	14.0(12.0,16.0)
# observed	305	115
PIP, cm H2O
Median(IQR)	32.0(25.0,37.0)	35.0(29.0,40.0)
# observed	273	101
FiO2
Median(IQR)	1.00(0.90,1.00)	1.00(0.94,1.00)
# observed	357	139
PaO2/FiO2
Median(IQR)	67(54,116)	64(54,86)
# observed	345	134
PCO2
Median(IQR)	53(42,69)	59(48,68)
# observed	372	144
Pre-ECMO Support
Prone positioning	20%(87)	36%(58)
# observed	444	161
Neuromuscular blockers	65%(288)	76%(122)
# observed	444	161
Inhaled pulmonary vasodilators	35%(157)	48%(77)
# observed	444	161
Any vasoactive support	63%(278)	56%(90)
# observed	444	161
Norepinephrine	31%(138)	33%(53)
# observed	444	161
Therapies, Immunomodulators
Any therapy	84%(372)	93%(150)
Glucocorticoids	73%(326)	84%(135)
IVIG	20%(88)	6%(10)
Anti-cytokine	24%(107)	22%(36)
Lopinavir/Ritonavir	1%(5)	2%(4)
JAK inhibition	2%(9)	3%(5)
Chloroquine/hydroxychloroquine	3%(12)	4%(7)
Remdesivir	50%(224)	60%(96)
# observed	444	161
Support type
Respiratory	70%(310)	100%(161)
Cardiac	24%(108)	0%(0)
ECPR	6%(26)	0%(0)
# observed	444	161

Patient Status & Complications

Outcomes
	Total	ARDS Cohort
Last known patient status
Discharged alive to home or acute rehabilitation	48%(213)	48%(77)
Discharged alive to long-term acute care or unspecified location	9%(39)	11%(18)
Discharged to another hospital	9%(40)	11%(18)
Remain in the hospital (discharged from ICU)	0%(2)	0%(0)
Remain in the ICU	2%(10)	2%(4)
In-hospital death	32%(140)	27%(44)
Tracheostomy	19%(81)	31%(47)
# observed	418	151
Select complications
Seizures	2%(10)	1%(2)
# observed	441	160
CNS infarction by US/CT/MRI	4%(17)	1%(1)
# observed	441	160
CNS hemorrhage by US/CT/MRI	4%(18)	4%(7)
# observed	441	160
Hemolysis	10%(44)	11%(18)
# observed	441	160
Oxygenator failure	10%(45)	18%(29)
# observed	441	160
Pump failure	2%(7)	1%(2)
# observed	441	160
Circuit change	12%(52)	14%(22)
# observed	441	160
Thrombosis/Clots in circuit component	5%(21)	8%(12)
# observed	441	160
Discharge location
Home	59%(171)	51%(58)
Transfer to LTAC or Rehab
Transfer to another hospital	14%(40)	16%(18)
Other/Unknown	8%(22)	6%(7)

*N/A - Data elements with n<5 are not displayed.

ELSO Ownership, No Rights to Publication, Disclaimer

The Dashboard content has been compiled and reported from a variety of sources, is not independently verified by ELSO, and is subject to change without notice. ELSO and its authorized agents and contractors make no representations or warranties about the quality, content, completeness, suitability, adequacy, sequence, accuracy, or timeliness of such content. ELSO disclaims any responsibility for any inaccuracy, whether by inclusion or omission, on the Dashboard or the Site, and disclaims any responsibility for subsequent change or withdrawal of data shown on the Dashboard or the Site, which is subject to alteration without notice. ELSO disclaims any and all warranties regarding this information and all liability whatsoever relating thereto. Any person who uses information obtained from this Dashboard does so at his or her own risk.

The Dashboard is provided as a public service to facilitate real-time sharing of information during the COVID-19 crisis for educational purposes only by health practitioners. ELSO owns the compilation of all data, and its use or publication by any third party is strictly forbidden. Publication or representation of this information as if it were statistically significant or part of a scientific study is irresponsible and misleading.

The tables are consistent with the Lancet Publication article but the data presented here is real time

Barbaro RP, MacLaren G, Boonstra PS, Iwashyna TJ, Slutsky AS, Fan E, Bartlett RH, Tonna JE, Hyslop R, Fanning JJ, Rycus PT, Hyer SJ, Anders MM, Agerstrand CL, Hryniewicz K, Diaz R, Lorusso R, Combes A, Brodie D, the Extracorporeal Life Support Organization. Extracorporeal Membrane Oxygenation Support in COVID-19: The Registry Report from the Extracorporeal Life Support Organization. Lancet. 2020; [In Press].

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