Barbaro RP, MacLaren G, Boonstra PS, et al. - Findings demonstrate worsening of mortality, during 2020, after extracorporeal membrane oxygenation (ECMO) for patients with COVID-19.

• This is a retrospective study to compare three groups of ECMO-supported patients with COVID-19 (aged ≥16 years) (n = 4812 in 2020) from the Extracorporeal Life Support Organization Registry and COVID-19 Addendum.

• At early-adopting centers (those using ECMO support for COVID-19 throughout 2020), the cumulative incidence of in-hospital death 90 days post-ECMO initiation was 36·9% in patients who initiated ECMO on or before May 1 (group A1) vs 51·9% after May 1 (group A2).

• It was 58·9% in patients using ECMO for COVID-19 at late-adopting centers only after May 1, 2020 (group B).

• Compared with group A2, a lower adjusted relative risk of in-hospital mortality 90 days post-ECMO was recorded for group A1 (hazard ratio 0·82), whereas a higher adjusted relative risk (1·42) was noted for group B.