143: Washington Dc Regional Ecmo Outcomes in Covid-19

Abstract

INTRODUCTION: COVID-19 mortality has disproportionately impacted racial and ethnic minorities in the United States. This disparity is particularly notable in Washington D.C. where African Americans make up 44% of the population, but 51% of COVID-19 infections and 75% of COVID-19 mortalities. Anecdotally, we saw high numbers of severe COVID-19 cases among young Hispanic adults and decided to explore this phenomenon by analyzing demographic characteristics for all COVID-19 patients who received VV-ECMO in Washington D.C. RESULTS:We performed a multicenter retrospective chart review of all COVID-19 patients who received VV-ECMO support from March 2020 to March 2021 at the two hospitals that provide ECMO in Washington D.C. Patient selection was uniform across both institutions, with basis in the original CESAR and EOLIA selection criteria. To future explore socioeconomic status (SES) as a corollary to ECMO cannulation, we merged patient zip codes with zip code median household income from the American Community Survey. There were 38 patients with COVID-19 who received VV-ECMO in Washington DC. Median age was 45 years and ages ranged from 28 to 65 years. 61% of patients were male and 71% were single. 57.9% of patients were Hispanic and 29.0% were non-Hispanic Black. 44.7% of patients were insured through Medicaid and another 13.2% were insured through a locally-funded public insurance designed for low-income persons ineligible for Medicaid. 63% of patients lacked primary care physicians. 94.7% were from D.C. area. 83.3% of patients from the D.C. area lived in zip codes with a median household income that is below the median household income for the city ($85,203).DISCUSSION: Only 11% of adults in Washington D.C. identify as Hispanic. Hispanics made up 19% of COVID infections in the city, but 58% of COVID-19 VV-ECMO cases. This suggests that, in our region, Hispanics may be over-represented among young and middle-aged adults with severe COVID-19 infections, which is why they are more likely to require ECMO support. These data highlight the great need to focus on this vulnerable population, with continued efforts to combat misinformation about the vaccines and partner with trusted persons in the community.

Racial and Ethnic Disparities in Veno-Venous Extracorporeal Membrane Oxygenation Mortality for Patients With Severe Coronavirus Disease-2019

“…Two other studies described results similar to our own, where Hispanic ECMO patients had disproportionately high mortality. 9,25 In the Washington, District of Columbia area, Hispanic patients comprised 58% of COVID-19 ECMO patients; however, they accounted for 64% of deaths. 9,25 Given the paucity of large cohort studies exploring racial/ethnic disparities in ECMO outcomes, our study adds to the existing literature.…”

“…9,25 In the Washington, District of Columbia area, Hispanic patients comprised 58% of COVID-19 ECMO patients; however, they accounted for 64% of deaths. 9,25 Given the paucity of large cohort studies exploring racial/ethnic disparities in ECMO outcomes, our study adds to the existing literature. Interestingly, in our study, Hispanic patients were youngest, had the longest median hospital stay, and highest mortality.…”