Outcomes of Extracorporeal Membrane Oxygenation in Patients with COVID-19 and Pulmonary Hypertension: An ELSO Registry Analysis
Authors' conclusion
Patients with acute or chronic PH who required ECMO for severe COVID-19 had higher risk profiles compared to those without PH. While outcomes for patients with acute PH were similar to those for patients without PH, the complication rate was significantly higher in acute PH. Chronic PH was associated with significantly higher, (although nonprohibitive) mortality and a higher risk of complications.
Study context
- Population
- Patients with severe COVID-19 who required extracorporeal membrane oxygenation (ECMO) support, global registry, 2020–2021
- Participants
- 7,465 / 177 / 147
- Exposure
- Acute pulmonary hypertension (PH) vs chronic PH vs no PH in COVID-19 patients on ECMO
- No-PHn = 7,465reference
- Acute-PHn = 177
- Chronic-PHn = 147
- Outcome
- Mortality
Methodological detailsExtracorporeal Life Support Organization registry, global
- Extracorporeal Life Support Organization registry
- Global
Main finding
As reported in the abstract
P = 0.07
Observational data: associations, not effects.
Further findings
Venoarterial ECMO use · 3-group comparison
P < 0.001
| Outcome | No-PH | Acute-PH | Chronic-PH | P value |
|---|---|---|---|---|
| Liver disease3-group comparison | 3.0% | — not stated in the abstract | — not stated in the abstract | P < 0.0001 |
— not stated in the abstract
- Liver disease: Abstract prints 26.5% for patients with chronic PH and 4.0% for "Chronic-PH"; group attribution ambiguous as printed
Safety
Overall complication rate · 3-group comparison
P < 0.0001
Overall complication rate
- Acute-PH had the highest incidences of limb ischemia and neurologic complications
Original publication
Outcomes of Extracorporeal Membrane Oxygenation in Patients with COVID-19 and Pulmonary Hypertension: An ELSO Registry Analysis. J Cardiothorac Vasc Anesth. Published 6 August 2025. doi:10.
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