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 17,411
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	380	708	17,502
North America	99	180	11,060
Europe	140	196	3,485
Asia Pacific	41	92	520
Latin America	75	190	1,265
SWAAC	25	50	1,171
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
569

COVID-19
In-hospital Mortality
33%

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	569	190
Age(years)
Median(IQR)	9(1,16)	13(2,17)
# observed	569	190
BMI, kg/m2
Median(IQR)	23(16,35)	31(21,40)
# observed	489	170
Sex
Male	50%(287)	52%(98)
Female	50%(282)	48%(92)
# observed	569	190
Race/Ethnicity
Black	19%(110)	16%(30)
White (Non-Hispanic)	38%(214)	39%(74)
Asian	4%(23)	4%(8)
Mid East, N African	3%(18)	4%(8)
Other	3%(15)	3%(5)
Unknown	5%(26)	5%(10)
Multiple	4%(23)	4%(7)
Hispanic	25%(140)	25%(48)
# observed	569	190
Pre-ECMO Comorbidities
No comorbidity	46%(263)	35%(66)
Cancer	4%(21)	4%(7)
Pregnancy	1%(3)	1%(2)
Immunocompromised	8%(46)	8%(15)
Diabetes	7%(41)	11%(21)
Pre-existing heart disease	7%(39)	1%(2)
Pre-existing lung disease	5%(29)	6%(11)
Pre-existing renal insuff.	2%(10)	1%(2)
Frailty	2%(12)	1%(2)
Asthma	12%(71)	18%(35)
BMI $> 30 \mathrm{kg}/\mathrm{m}^2$	27%(155)	46%(87)
Hypertension	5%(29)	10%(19)
# observed	569	190
Acute illness
ARDS	51%(290)	100%(190)
Acute heart failure	20%(115)	4%(8)
Myocarditis	13%(76)	1%(1)
Acute kidney injury	19%(108)	18%(34)
# observed	569	190
Pre-ECMO Cardiac Arrest
Yes	23%(128)	6%(11)
No	77%(439)	94%(179)
# observed	567	190
Pre-ECMO Co-Infection
No Co-infection	53%(300)	45%(86)
Bacterial pneumonia	32%(184)	44%(84)
Co-viral infection	22%(123)	21%(40)
Blood stream infection	14%(80)	18%(34)
Urinary tract infection	5%(27)	10%(19)
# observed	569	190

Pre-ECMO Interventions

Support and therapies. All categorical variables are given as 'percentage (count)'
	PreECLS	PreECLS
Number cases	569	190
Noninvasive ventilation
Noninvasive ventilation prior to intubation	65%(370)	84%(160)
BiPAP	31%(179)	48%(91)
CPAP	10%(57)	13%(24)
HFNC	43%(247)	55%(104)
# observed	569	190
Pre-ECLS intubation (days)
Median(IQR)	0.6(0.2,3.0)	1.5(0.3,4.5)
# observed	483	169
Ventilator mode
Conventional	82%(405)	83%(143)
# observed	492	173
PEEP, cm H2O
Median(IQR)	10.0(8.0,14.0)	14.0(10.0,16.0)
# observed	382	136
PIP, cm H2O
Median(IQR)	31.0(24.0,37.0)	35.0(29.0,39.0)
# observed	347	122
FiO2
Median(IQR)	1.00(0.90,1.00)	1.00(0.94,1.00)
# observed	450	162
PaO2/FiO2
Median(IQR)	69(54,123)	65(54,93)
# observed	430	156
PCO2
Median(IQR)	54(42,69)	60(49,71)
# observed	464	166
Pre-ECMO Support
Prone positioning	17%(99)	34%(65)
# observed	569	190
Neuromuscular blockers	64%(365)	75%(143)
# observed	569	190
Inhaled pulmonary vasodilators	33%(185)	45%(85)
# observed	569	190
Any vasoactive support	64%(361)	55%(104)
# observed	568	190
Norepinephrine	32%(179)	33%(62)
# observed	568	190
Therapies, Immunomodulators
Any therapy	80%(458)	91%(173)
Glucocorticoids	71%(402)	84%(159)
IVIG	19%(110)	6%(12)
Anti-cytokine	22%(124)	24%(45)
Lopinavir/Ritonavir	1%(4)	2%(3)
JAK inhibition	2%(10)	3%(5)
Chloroquine/hydroxychloroquine	2%(12)	4%(7)
Remdesivir	48%(275)	57%(108)
# observed	569	190
Support type
Respiratory	66%(375)	100%(190)
Cardiac	26%(147)	0%(0)
ECPR	8%(47)	0%(0)
# observed	569	190

Patient Status & Complications

Outcomes
	Total	ARDS Cohort
Last known patient status
Discharged alive to home or acute rehabilitation	47%(266)	47%(90)
Discharged alive to long-term acute care or unspecified location	7%(42)	10%(19)
Discharged to another hospital	10%(59)	12%(23)
Remain in the hospital (discharged from ICU)	0%(2)	1%(1)
Remain in the ICU	1%(3)	0%(0)
In-hospital death	35%(197)	30%(57)
Tracheostomy	18%(97)	31%(57)
# observed	541	181
Select complications
Seizures	3%(15)	1%(2)
# observed	567	190
CNS infarction by US/CT/MRI	5%(26)	1%(1)
# observed	567	190
CNS hemorrhage by US/CT/MRI	4%(22)	3%(6)
# observed	567	190
Hemolysis	10%(56)	12%(22)
# observed	567	190
Oxygenator failure	10%(54)	16%(31)
# observed	567	190
Pump failure	1%(7)	1%(2)
# observed	567	190
Circuit change	11%(64)	14%(27)
# observed	567	190
Thrombosis/Clots in circuit component	5%(27)	7%(14)
# observed	567	190
Discharge location
Home	58%(213)	50%(66)
Transfer to LTAC or Rehab
Transfer to another hospital	16%(59)	17%(23)
Other/Unknown	6%(23)	6%(8)

*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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