Tran Dena H, Peng Carol Chiung-Hui, Wolde-Rufael Daniel A, Devkota Hari, Diaz-Abad Montserrat, Baghdadi Jonathan, Chow R Dobbin, Verceles Avelino C
Department of Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, MD, USA.
Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore, MD, USA.
J Community Hosp Intern Med Perspect. 2021 Jun 21;11(4):480-484. doi: 10.1080/20009666.2021.1918442.
: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged from Wuhan, China in December 2019 and is the strain of coronavirus that causes coronavirus disease 2019 (COVID-19). Approximately one-third of the patients with COVID-19 require intensive care unit (ICU) admission, and almost 30% of the patients develop acute respiratory distress syndrome (ARDS). Extracorporeal membrane oxygenation (ECMO) is used as salvage therapy for severe ARDS. The role of ECMO in the treatment of COVID-19 remains unclear, although there is emerging evidence that this approach may be an effective salvage therapy for severe ARDS. : We present a case of a previously healthy 39-year-old Hispanic male who presented to the hospital with flu-like symptoms, including headache, fatigue, and myalgia for 8 days in late April 2020. He denied dyspnea on exertion. The patient's symptoms progressed, resulting in pneumonia and acute respiratory distress syndrome (ARDS). The patient was managed with prone positioning, convalescent plasma and veno-venous extracorporeal membrane oxygenation (VV-ECMO) for 35 days. The patient successfully recovered and was able to ambulate independently and was discharged home from an acute care hospital without oxygen supplementation on hospital day 63. : We present one of the first few documented cases of ECMO for severe ARDS due to COVID-19. After a prolonged hospital course requiring VV-ECMO, the patient was discharged home from an acute care hospital without oxygen requirement and ambulated independently, likely as a result of daily aggressive mobility-focused rehabilitation.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）于2019年12月在中国武汉出现，是引发2019冠状病毒病（COVID-19）的冠状病毒毒株。约三分之一的COVID-19患者需要入住重症监护病房（ICU），近30%的患者会发展为急性呼吸窘迫综合征（ARDS）。体外膜肺氧合（ECMO）被用作重症ARDS的挽救治疗方法。尽管越来越多的证据表明这种方法可能是重症ARDS的有效挽救疗法，但ECMO在COVID-19治疗中的作用仍不明确。
我们报告一例病例，一名39岁既往健康的西班牙裔男性，于2020年4月下旬因出现类似流感的症状（包括头痛、乏力和肌痛）达8天而入院。他否认活动时呼吸困难。患者症状进展，导致肺炎和急性呼吸窘迫综合征（ARDS）。该患者接受俯卧位通气、恢复期血浆和静脉-静脉体外膜肺氧合（VV-ECMO）治疗35天。患者成功康复，能够独立行走，并于住院第63天从急症医院出院，无需吸氧。
我们报告了首批几例因COVID-19导致重症ARDS而使用ECMO治疗的病例之一。经过一段需要VV-ECMO的漫长住院过程后，患者从急症医院出院回家，无需吸氧且能独立行走，这可能得益于每日积极的以活动为重点的康复治疗。
