Extracorporeal membrane oxygenation to treat a 15-year-old patient with severe coronavirus disease 2019 (COVID-19) respiratory failure

Kakuturu, Jahnavi; McCluskey, Casey K.; Casey, Francis L.; Çïçek, Sertaç; Hayanga, J.W. Awori

doi:10.1016/j.xjtc.2021.03.012

Cited by 5 publications

(8 citation statements)

References 5 publications

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“…We identified 312 articles through the initial database search and the subsequent manual search. After removing 207 items based on the title and abstract, we reviewed the full text of 105 articles and included 44 studies (total number of ECMO use = 110) in the systematic review (8, 9, 11–14, 19–56). In particular, three studies with relatively large sample sizes (number of ECMO use = 42, 31, and 69) were excluded because they did not provide clinical data of patients on ECMO separately (57–59).…”

Section: Resultsmentioning

confidence: 99%

“…In particular, three studies with relatively large sample sizes (number of ECMO use = 42, 31, and 69) were excluded because they did not provide clinical data of patients on ECMO separately (57–59). Of the 44 articles, 18 were retrospective observational studies (8, 9, 14, 19–33), four were case series (11–13, 34), and 22 were case reports (35–56). Among the total of 22 observational studies and case series, 10 studies included only one ECMO patient (12, 14, 27–34).…”

Section: Resultsmentioning

confidence: 99%

“…ECMO use details are summarized in Supplemental Table 2 (http://links.lww.com/PCC/C260). The indications for ECMO were specified in 36 studies (8, 9, 11–13, 20–23, 27, 29–31, 33–48, 50–56). The two major indications for ECMO were MIS-C (52% [47/90]) and ARDS (42% [38/90]).…”

Section: Resultsmentioning

confidence: 99%

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Extracorporeal Membrane Oxygenation in Children With COVID-19: A Systematic Review and Meta-Analysis*

Watanabe

Yasuhara

Karube

et al. 2022

Pediatric Critical Care Medicine

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OBJECTIVES: The indication, complications, and outcomes of extracorporeal membrane oxygenation (ECMO) in children with COVID-19–related illnesses remain unelucidated. Our study aimed to investigate the characteristics and outcomes of ECMO in children with COVID-19–related illnesses. DATA SOURCES: We searched PubMed and EMBASE databases in March 2022. STUDY SELECTION: We retrieved all studies involving children (age ≤ 18 yr) with COVID-19–related illnesses who received ECMO. DATA EXTRACTION: Two authors independently extracted data and assessed the risk of bias. Mortality, successful weaning rate, and complications while on ECMO were synthesized by a one-group meta-analysis using a random-effect model. Meta-regression was performed to explore the risk factors for mortality. DATA SYNTHESIS: We included 18 observational studies, four case series, and 22 case reports involving 110 children with COVID-19–related illnesses receiving ECMO. The median age was 8 years (range, 10 d to 18 yr), and the median body mass index was 21.4 kg/m 2 (range, 12.3–56.0 kg/m 2 ). The most common comorbidities were obesity (11% [7/63]) and congenital heart disease (11% [7/63]), whereas 48% (30/63) were previously healthy. The most common indications for ECMO were multisystem inflammatory syndrome in children (52% [47/90]) and severe acute respiratory distress syndrome (40% [36/90]). Seventy-one percent (56/79) received venoarterial-ECMO. The median ECMO runtime was 6 days (range, 3–51 d) for venoarterial ECMO and 11 days (range, 3–71 d) for venovenous ECMO. The mortality was 26.6% (95% CI, 15.9–40.9), and the successful weaning rate was 77.0% (95% CI, 55.4–90.1). Complications were seen in 37.0% (95% CI, 23.1–53.5) while on ECMO, including stroke, acute kidney injury, pulmonary edema, and thromboembolism. Corticosteroids and IV immunoglobulin therapies were associated with lower mortality. CONCLUSIONS: The mortality of children on ECMO for COVID-19 was relatively low. This invasive treatment can be considered as a treatment option for critically ill children with COVID-19.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Extracorporeal Membrane Oxygenation in Children With COVID-19: A Systematic Review and Meta-Analysis*

Watanabe

Yasuhara

Karube

et al. 2022

Pediatric Critical Care Medicine

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“…Fifty-eight females were enrolled and 59 males. Ages ranged from 15 7 to 95 years of age. The average age for both females and males was 65 years old and the difference in age was not statistically significant.…”

Section: Resultsmentioning

confidence: 99%

Serial Convalescent Plasma Infusions for the Initial COVID-19 Infections in the Appalachian Region of West Virginia

Peppers

Shmookler

Stanley

et al. 2022

Allergy�Rhinol (Providence)

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Purpose The rapid spread of SARS-CoV-2, the virus that is responsible for causing COVID-19, has presented the medical community with another example of when convalescent plasma (CP) is still used today. The ability to standardize CP at the onset of a pandemic is unlikely to exist in a reliable and uniformly reproducible way. We hypothesized that CP of unknown strength given in a serial manner will promote health and reduce mortality in those inflicted with COVID-19. Methods Participants were given up to 8 CP-units depending on their condition upon entry into the study and their response. Results 102 out of 117 participants were given CP. The earlier a participant received CP corelated with survival (p = 0.0004). The number of CP-units given, throughout all the clinical severities, was not significant with outcomes, p = 0.3947. A higher number of CP-units given to the severe/critical participants (without biological immunosuppressants or restrictive lung disease) did correlate with survival p = 0.0116 (2.8 vs. 2 units). Lower platelets on admission corelated with mortality. Platelet levels increase correlated with CP infusions p < 0.0001. Conclusion This study supports the serial use of CP of unknown strength based on clinical response for those infected with COVID-19. The use of 3–4 units of CP was found to be statistically significant for survival for severe and critical participants without restrictive lung disease and chronic biological immunosuppression. Increased platelet levels after CP infusions supports that CP is promoting overall health regardless of outcomes.

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“…In any case, these patients may benefit significantly from treatment with neutralizing monoclonal antibodies 49 and, in cases of severe evolution, with IFN-beta or plasma exchange. 40 , 50 …”

Section: Methodsmentioning

confidence: 99%

Understanding COVID-19 in children: immune determinants and post-infection conditions

Rotulo

2023

Pediatr Res

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Coronavirus disease 2019 in children presents with milder clinical manifestations than in adults. On the other hand, the presence of a wide range of inflammatory manifestations, including multisystem inflammatory syndrome in children (MIS-C), in the period after infection suggests a particular susceptibility of some children toward severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Both protective factors that prevent evolution to severe forms and risk factors for post-infectious conditions are likely to be found in age-related differences in the immune system. The prompt innate response with type I IFN production and the generation of neutralizing antibodies play a crucial role in containing the infection. The greater number of naive and regulatory cells in children helps to avoid the cytokine storm while the causes of the intense inflammatory response in MIS-C need to be elucidated. This review aims to analyze the main results of the recent literature assessing immune response to SARS-CoV-2 over the pediatric age group. We summarized such observations by dividing them into innate and acquired immunity, then reporting how altered immune responses can determine post-infectious conditions. Impact The main immune markers of acute SARS-CoV-2 infection in children are summarized in this review. This paper reports a broad overview of age-related differences in the immune response to SARS-CoV-2 and emerging post-infection conditions. A summary of currently available therapies for the pediatric age group is provided.

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Extracorporeal membrane oxygenation to treat a 15-year-old patient with severe coronavirus disease 2019 (COVID-19) respiratory failure

Cited by 5 publications

References 5 publications

Extracorporeal Membrane Oxygenation in Children With COVID-19: A Systematic Review and Meta-Analysis*

Extracorporeal Membrane Oxygenation in Children With COVID-19: A Systematic Review and Meta-Analysis*

Serial Convalescent Plasma Infusions for the Initial COVID-19 Infections in the Appalachian Region of West Virginia

Understanding COVID-19 in children: immune determinants and post-infection conditions

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