Immunomodulators in patients receiving extracorporeal membrane oxygenation for COVID-19: a propensity-score adjusted analysis of the ELSO registry
Authors' conclusion
In this cohort study, we found that immunomodulators, in particular corticosteroids, were associated with significantly higher mortality amongst patients receiving ECMO for COVID-19, after adjusting for potential confounding variables and propensity score.
Study context
- Population
- Patients receiving extracorporeal membrane oxygenation (ECMO) for COVID-19, ELSO registry, 1 January 2020 to 31 December 20216,169 received immunomodulators
- Participants
- 7,181 patients
- Exposure
- Corticosteroids only, other immunomodulators only, or both vs no immunomodulators, before or during ECMO
- Outcome
- Survival time
- Follow-up
- 90 days
Methodological detailspropensity-score adjusted, registry analysis
- Propensity-score adjusted
- Registry analysis
Main finding
As reported in the abstract
90-day survival
Each group vs no immunomodulatorsEstimate (95% CI)
Corticosteroids onlysignificantly shorter survival time
HR for death (HR >1 = shorter survival time) 1.13(1.01–1.28)
Corticosteroids + other immunomodulatorssignificantly shorter survival time
HR for death (HR >1 = shorter survival time) 1.21(1.07–1.54)
Other immunomodulators onlysignificantly longer survival time
HR for death (HR <1 = longer survival time) 0.79(0.66–0.96)
Observational data: associations, not effects.
Safety
- Receipt of immunomodulators (all three groups) associated with an increase in secondary infections
Original publication
Immunomodulators in patients receiving extracorporeal membrane oxygenation for COVID-19: a propensity-score adjusted analysis of the ELSO registry. Ann Intensive Care. Published 20 August 2024. doi:10.
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