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ORIGINAL RESEARCH article

Front. Med.

Sec. Intensive Care Medicine and Anesthesiology

This article is part of the Research TopicExtracorporeal Organ Support: Innovations and Challenges in Critical CareView all 17 articles

Survival and Recovery: 24-Month Outcomes for Critically Ill COVID-19 Patients Receiving ECMO

Provisionally accepted
Zsuzsanna UlakcsaiZsuzsanna Ulakcsai1*Zsofia DohyZsofia Dohy1Liliana SzaboLiliana Szabo1Dorottya BallaDorottya Balla1Csongor MeskóCsongor Meskó1Balint Karoly LakatosBalint Karoly Lakatos1Daniele Fontanini MariastefanoDaniele Fontanini Mariastefano1Dorottya FésüDorottya Fésü2Zsofia OcsovszkyZsofia Ocsovszky1József OtohalJózsef Otohal1Blanka EhrenbergerBlanka Ehrenberger1Zsófia SzabóZsófia Szabó3Geza Tamas SzaboGeza Tamas Szabo3Endre NemethEndre Nemeth1Veronika MüllerVeronika Müller2Gyorgy NagyGyorgy Nagy4Hajnalka VagoHajnalka Vago1Bela MerkelyBela Merkely1
  • 1Heart and Vascular Center, Semmelweis University, Budapest, Hungary
  • 2Department of Pulmonology, Semmelweis University, Budapest, Hungary
  • 3Department of Laboratory Medicine, Semmelweis University, Budapest, Hungary
  • 4Department of Rheumatology and Immunology, Semmelweis University, Budapest, Hungary

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Background: Veno-venous extracorporeal membrane oxygenation (V-V ECMO) was used for patients with severe COVID-19 pneumonia. The aim of our study was to assess the long-term outcomes and quality of life of the surviving patients. Methods: This single-center observational study was performed among patients who were discharged after V-V ECMO treatment with COVID-19 pneumonia. During the 2-year follow-up period, different organ functions and quality of life parameters were evaluated three times after discharge. As a control group, SARS-CoV-2 infection positive patients were included. Results: Thirty-five patients underwent V-V ECMO treatment, of whom 11 patients survived. The study population consists of 9 patients for the follow-up (2 patients did not consent to follow-up examinations). On lung CT, the occurrence of residual fibrotic banding was 22% at discharge, and increased to 89% at 24th month follow-up, while lung function tests were normal. On echocardiography, patients had a mildly elevated right ventricle end-diastolic diameter at the post discharge period, which normalized during follow-up (baseline: 37.6±2.9 mm, follow-up: 35.6±2.2 mm, p<0.05). In the ECMO group both humoral and cellular immune responses remained elevated (Quantiferon Ag1 p=0.005, Quantiferon Ag2 p=0.0059, Quantiferon Ag3 p=0.0012, IgG Roche p= 0.0037). Among the psychological factors, significant correlation was observed between ECMO duration and symptoms of depression (r = 0.727; p<0.05), anxiety (r = 0.848; p<0.01), and posttraumatic stress (r= 0.834; p<0.01), furthermore, a negative correlation with positive affectivity (r = -0.868; p<0.01) presented itself. SF-36 scores improved significantly from the 6-month to the 24-month follow-up (median 50% vs. 80%, p<0.01). The mean body mass index increased from 29 to 35

Keywords: COVID-19, ECMO, immune response, long-term follow-up, multidisciplinary approach, Quality of Life, SARS-CoV-2

Received: 23 Oct 2025; Accepted: 05 Dec 2025.

Copyright: © 2025 Ulakcsai, Dohy, Szabo, Balla, Meskó, Lakatos, Fontanini Mariastefano, Fésü, Ocsovszky, Otohal, Ehrenberger, Szabó, Szabo, Nemeth, Müller, Nagy, Vago and Merkely. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Zsuzsanna Ulakcsai

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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