Genzor Samuel, Pobeha Pavol, Šimek Martin, Jakubec Petr, Mizera Jan, Vykopal Martin, Sova Milan, Vaněk Jakub, Praško Jan
Department of Respiratory Medicine and Tuberculosis, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, 779 00 Olomouc, Czech Republic.
Center for Digital Health, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, 779 00 Olomouc, Czech Republic.
Life (Basel). 2023 Apr 20;13(4):1054. doi: 10.3390/life13041054.
Severe respiratory failure is one of the most serious complications of coronavirus disease 2019 (COVID-19). In a small proportion of patients, mechanical ventilation fails to provide adequate oxygenation and extracorporeal membrane oxygenation (ECMO) is needed. The surviving individuals need long-term follow-up as it is not clear what their prognosis is.
To provide a complex clinical picture of patients during follow-up exceeding one year after the ECMO therapy due to severe COVID-19.
All subjects involved in the study required ECMO in the acute stage of COVID-19. The survivors were followed-up for over one year at a specialized respiratory medical center.
Of the 41 patients indicated for ECMO, 17 patients (64.7% males) survived. The average age of survivors was 47.8 years, and the average BMI was 34.7 kg·m. The duration of ECMO support was 9.4 days. A mild decrease in vital capacity (VC) and transfer factor (DLCO) was observed on the initial follow-up visit (82.1% and 60%, respectively). VC improved by 6.2% and by an additional 7.5% after 6 months and 1 year, respectively. DLCO improved by 21.1% after 6 months and remained stable after 1 year. Post-intensive care consequences included psychological problems and neurological impairment in 29% of patients; 64.7% of the survivors got vaccinated against SARS-CoV-2 within 12 months of hospitalization and 17.6% experienced reinfection with a mild course.
The COVID-19 pandemic has significantly increased the need for ECMO. Patients' quality of life after ECMO is temporarily significantly reduced but most patients do not experience permanent disability.
严重呼吸衰竭是2019冠状病毒病（COVID-19）最严重的并发症之一。在一小部分患者中，机械通气无法提供足够的氧合，因此需要体外膜肺氧合（ECMO）。由于不清楚其预后情况，幸存个体需要长期随访。
提供因重症COVID-19接受ECMO治疗一年以上患者随访期间的综合临床情况。
所有参与本研究的受试者在COVID-19急性期均需要ECMO。幸存者在一家专业呼吸医学中心接受了一年以上的随访。
在41例接受ECMO治疗的患者中，17例（64.7%为男性）存活。幸存者的平均年龄为47.8岁，平均体重指数为34.7kg·m²。ECMO支持时间为9.4天。在首次随访时观察到肺活量（VC）和肺一氧化碳弥散量（DLCO）轻度下降（分别为82.1%和60%）。VC在6个月和1年后分别提高了6.2%和7.5%。DLCO在6个月后提高了21.1%，1年后保持稳定。重症监护后的后果包括29%的患者出现心理问题和神经功能障碍；64.7%的幸存者在住院12个月内接种了抗SARS-CoV-2疫苗，17.6%的患者经历了轻度再感染。
COVID-19大流行显著增加了对ECMO的需求。ECMO治疗后患者的生活质量暂时显著降低，但大多数患者不会出现永久性残疾。
