One-Year Mental and Physical Health Assessment in Survivors after Extracorporeal Membrane Oxygenation for COVID-19–related Acute Respiratory Distress Syndrome
Juliette Chommeloux, Simon Valentin, Hadrien Winiszewski, Mélanie Adda, Marc Pineton de Chambrun, Quentin Moyon, Alexis Mathian, Gilles Capellier, Christophe Guervilly, Bruno Lévy, Pierre Jaquet, Romain Sonneville, Guillaume Voiriot, Alexandre Demoule, Samia Boussouar, Benoît Painvin, Guillaume Lebreton, Alain Combes, Matthieu Schmidt
Abstract
Abstract Rationale Long-term outcomes of patients with coronavirus disease (COVID-19)–related acute respiratory distress syndrome treated with extracorporeal membrane oxygenation (ECMO) are unknown. Objectives To assess physical examination, pulmonary function tests, anxiety, depression, post-traumatic stress disorder and quality of life at 6 and 12 months after ECMO onset. Methods Multicenter, prospective study in patients who received ECMO for COVID-19 acute respiratory distress syndrome from March to June 2020 and survived hospital discharge. Measurements and Main Results Of 80 eligible patients, 62 were enrolled in seven French ICUs. ECMO and invasive mechanical ventilation duration were 18 (11–25) and 36 (27–62) days, respectively. All were alive, but only 19/50 (38%) returned to work and 13/42 (31%) had recovered a normal sex drive at 1 year. Pulmonary function tests were almost normal at 6 months, except for Dl CO, which was still impaired at 12 months. Mental health, role-emotional, and role-physical were the most impaired domain compared with patients receiving ECMO who did not have COVID-19. One year after ICU admission, 19/43 (44%) patients had significant anxiety, 18/43 (42%) had depression symptoms, and 21/50 (42%) were at risk for post-traumatic stress disorders. Conclusions Despite the partial recovery of the lung function tests at 1 year, the physical and psychological function of this population remains impaired. Based on the comparison with long-term follow-up of patients receiving ECMO who did not have COVID-19, poor mental and physical health may be more related to COVID-19 than to ECMO in itself, although this needs confirmation.