Barbaro RP, MacLaren G, Boonstra PS, et al. - Over the course of the COVID-19 pandemic, there had been a change in the care of patients with COVID-19 and an increase in the use of extracorporeal membrane oxygenation (ECMO). Patient selection, treatments, outcomes, and ECMO center characteristics over this period are described herein.

• Three groups of ECMO-supported patients with COVID-19 (aged ≥16 years) are compared in this retrospective analysis of the Extracorporeal Life Support Organization Registry and COVID-19 Addendum.

• At early-adopting centers—i.e., those using ECMO support for COVID-19 throughout 2020—patients who initiated ECMO on or before May 1, 2020 (group A1) were compared with those initiating between May 2 and Dec 31, 2020 (group A2).

• In group B, included were patients who were provided ECMO for COVID-19 at late-adopting centers only after May 1, 2020.

• In 2020, ECMO was provided to 4,812 patients with COVID-19 across 349 centers within 41 countries.

• For patients with COVID-19, mortality after ECMO worsened during 2020.

• A lower adjusted relative risk of in-hospital mortality 90 days after ECMO was recorded for group A1 patients vs patients in group A2, whereas a higher adjusted relative risk was observed for group B patients.