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[Translated article] Histology Study of Postmortem Lung Biopsies in Patients With Covid-19 Pneumonia Estudio histologico mediante biopsia pulmonar post mortem en pacientes con neumonia por COVID-19

ABSTRACT:

SUBMITTER: Sellares J

PROVIDER: S-EPMC9009762 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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Project description:Introduction One of the great challenges during the COVID-19 pandemic was the management of ventilatory support. Extracorporeal membrane oxygenation (ECMO) was the main strategy for the management of refractory acute respiratory distress syndrome. Objective Retrospective, multicentre cohort study of adult patients who required extracorporeal membrane oxygenation (ECMO) in participating centers. Clinical and paraclinical characteristics were recorded. A comparison was made between surviving and non-surviving patients. In addition, time from symptom onset to ECMO placement, time from mechanical ventilation, and cannulation were analyzed. Material and methods Retrospective, multicentre cohort study of adult patients who required extracorporeal membrane oxygenation (ECMO) in participating centers. Clinical and paraclinical characteristics were recorded. A comparison was made between surviving and non-surviving patients. In addition, time from symptom onset to ECMO placement, time from mechanical ventilation, and cannulation were analyzed. Results Twenty-six patients were included in the analysis. Mortality during ECMO was 42.3% (n = 11) and overall hospital mortality was 65.3% (n = 17). The patient cohort did not differ in terms of sociodemographic characteristics and predictors of mortality at ICU admission between survivors and non-survivors. Mobile ECMO was performed in 10 patients, while 16 were cannulated in situ at the participating centers. The median time from symptom onset to ECMO was 14.5 days (IQR 10.7–21.5), 11 days (IQR 9.5–15.5) in the survivor group, and 17 days (IQR 12.5–27) in non-survivors. The median IMV time was 28.5 (IQR 13–38.25) days. Driving pressure (12 vs 10 cmH2O; p < .01), compliance (37.2 vs 21.4 ml/cmH2O; p < .01), and mechanical power (17.4 vs 11.3 J/min; p = .051) of the respiratory system showed statistically significant differences when comparing survivors and non-survivors, during the 3rd day of ECMO support. Conclusion In our cohort, mortality after ECMO and after 30 days of hospital stay, was 42.3%, similar to that stated on the extracorporeal life support organization (ELSO) COVID-19 registry dashboard. Information about patients with COVID-19 who required ECMO during the first wave in Argentina was provided in this analysis.

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[Translated article] Histology Study of Postmortem Lung Biopsies in Patients With Covid-19 Pneumonia Estudio histologico mediante biopsia pulmonar post mortem en pacientes con neumonia por COVID-19

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