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 16,857
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	404	701	16,942
North America	96	176	10,824
Europe	137	197	3,395
Asia Pacific	31	65	451
Latin America	111	208	1,148
SWAAC	29	55	1,124
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
15,442

COVID-19
In-hospital Mortality
47%

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	15442	11495
Age(years)
Median(IQR)	47(37,56)	47(38,56)
# observed	15442	11495
BMI, kg/m2
Median(IQR)	32(28,37)	32(28,38)
# observed	14367	10676
Sex
Male	68%(10555)	70%(8016)
Female	32%(4883)	30%(3476)
# observed	15438	11492
Race/Ethnicity
Black	11%(1658)	10%(1179)
White (Non-Hispanic)	44%(6800)	43%(4983)
Asian	8%(1312)	8%(919)
Mid East, N African	4%(683)	5%(569)
Other	3%(451)	3%(334)
Unknown	5%(754)	5%(584)
Multiple	5%(775)	6%(652)
Hispanic	19%(3009)	20%(2275)
# observed	15442	11495
Pre-ECMO Comorbidities
No comorbidity	26%(3950)	24%(2787)
Cancer	2%(271)	2%(188)
Pregnancy	4%(630)	4%(481)
Immunocompromised	5%(729)	5%(538)
Diabetes	23%(3626)	24%(2799)
Pre-existing heart disease	4%(632)	3%(317)
Pre-existing lung disease	4%(590)	4%(442)
Pre-existing renal insuff.	3%(463)	3%(322)
Frailty	1%(130)	1%(73)
Asthma	10%(1570)	10%(1204)
BMI $> 30 \mathrm{kg}/\mathrm{m}^2$	49%(7594)	52%(5934)
Hypertension	31%(4794)	32%(3706)
# observed	15442	11495
Acute illness
ARDS	79%(12158)	100%(11495)
Acute heart failure	8%(1295)	5%(581)
Myocarditis	2%(357)	1%(63)
Acute kidney injury	26%(4090)	27%(3111)
# observed	15442	11495
Pre-ECMO Cardiac Arrest
Yes	6%(992)	3%(342)
No	94%(14308)	97%(11042)
# observed	15300	11384
Pre-ECMO Co-Infection
No Co-infection	48%(7487)	46%(5262)
Bacterial pneumonia	45%(6884)	48%(5514)
Co-viral infection	9%(1447)	9%(1030)
Blood stream infection	18%(2799)	19%(2218)
Urinary tract infection	7%(1156)	8%(961)
# observed	15440	11493

Pre-ECMO Interventions

Support and therapies. All categorical variables are given as 'percentage (count)'
	PreECLS	PreECLS
Number cases	15442	11495
Noninvasive ventilation
Noninvasive ventilation prior to intubation	76%(11776)	80%(9225)
BiPAP	38%(5867)	41%(4729)
CPAP	13%(1955)	12%(1382)
HFNC	51%(7909)	55%(6346)
# observed	15442	11495
Pre-ECLS intubation (days)
Median(IQR)	2.8(0.8,5.9)	3.2(1.0,6.1)
# observed	12884	9666
Ventilator mode
Conventional	96%(12634)	97%(9722)
# observed	13187	10027
PEEP, cm H2O
Median(IQR)	14.0(10.0,16.0)	14.0(10.0,16.0)
# observed	11709	9046
PIP, cm H2O
Median(IQR)	33.0(30.0,38.0)	34.0(30.0,38.0)
# observed	9409	7220
FiO2
Median(IQR)	1.00(0.95,1.00)	1.00(1.00,1.00)
# observed	11611	8831
PaO2/FiO2
Median(IQR)	70(57,91)	70(57,89)
# observed	11345	8637
PCO2
Median(IQR)	60(49,75)	61(51,75)
# observed	12063	9140
Pre-ECMO Support
Prone positioning	52%(7991)	56%(6448)
# observed	15378	11447
Neuromuscular blockers	68%(10406)	72%(8251)
# observed	15379	11445
Inhaled pulmonary vasodilators	28%(4328)	31%(3519)
# observed	15378	11447
Any vasoactive support	57%(8805)	56%(6393)
# observed	15371	11441
Norepinephrine	51%(7805)	51%(5815)
# observed	15371	11441
Therapies, Immunomodulators
Any therapy	88%(13512)	91%(10423)
Glucocorticoids	79%(12137)	82%(9414)
IVIG	3%(412)	2%(219)
Anti-cytokine	22%(3377)	24%(2779)
Lopinavir/Ritonavir	2%(270)	2%(222)
JAK inhibition	4%(555)	4%(472)
Chloroquine/hydroxychloroquine	7%(1021)	7%(829)
Remdesivir	49%(7494)	52%(5964)
# observed	15442	11495
Support type
Respiratory	93%(14320)	100%(11471)
Cardiac	6%(856)	0%(11)
ECPR	2%(266)	0%(13)
# observed	15442	11495

Patient Status & Complications

Outcomes
	Total	ARDS Cohort
Last known patient status
Discharged alive to home or acute rehabilitation	26%(4089)	26%(2969)
Discharged alive to long-term acute care or unspecified location	12%(1810)	13%(1462)
Discharged to another hospital	12%(1825)	11%(1282)
Remain in the hospital (discharged from ICU)	0%(5)	0%(3)
Remain in the ICU	0%(47)	0%(31)
In-hospital death	50%(7666)	50%(5748)
Tracheostomy	46%(6543)	51%(5334)
# observed	14071	10497
Select complications
Seizures	1%(120)	1%(86)
# observed	15378	11441
CNS infarction by US/CT/MRI	2%(261)	1%(157)
# observed	15378	11441
CNS hemorrhage by US/CT/MRI	6%(980)	7%(775)
# observed	15378	11441
Hemolysis	7%(1133)	8%(877)
# observed	15378	11441
Oxygenator failure	21%(3211)	23%(2666)
# observed	15378	11441
Pump failure	2%(322)	2%(255)
# observed	15378	11441
Circuit change	11%(1707)	12%(1367)
# observed	15378	11441
Thrombosis/Clots in circuit component	3%(517)	4%(416)
# observed	15378	11441
Discharge location
Home	31%(2386)	30%(1734)
Transfer to LTAC or Rehab
Transfer to another hospital	24%(1825)	22%(1282)
Other/Unknown	6%(442)	5%(308)

*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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