This is precisely why you need to get anticoagulation immediately, to prevent COVID-19 from getting to respiratory failure. 37% death rate is not good.
Heparin binds to cells at a site adjacent to ACE2, the portal for SARS-CoV-2 infection, and "potently" blocks the virus, which could open up therapy options.
Anticoagulation Again Shown to Improve Survival in COVID-19 Patients;-Mortality risk about 50% lower
I'm not medically trained so I know nothing, don't listen to me.
The latest here:
Extracorporeal membrane oxygenation support in COVID-19: an international cohort study of the Extracorporeal Life Support Organization registry
- et al.
Summary
Background
Multiple
major health organisations recommend the use of extracorporeal membrane
oxygenation (ECMO) support for COVID-19-related acute hypoxaemic
respiratory failure. However, initial reports of ECMO use in patients
with COVID-19 described very high mortality and there have been no
large, international cohort studies of ECMO for COVID-19 reported to
date.
Methods
We used data
from the Extracorporeal Life Support Organization (ELSO) Registry to
characterise the epidemiology, hospital course, and outcomes of patients
aged 16 years or older with confirmed COVID-19 who had ECMO support
initiated between Jan 16 and May 1, 2020, at 213 hospitals in 36
countries. The primary outcome was in-hospital death in a time-to-event
analysis assessed at 90 days after ECMO initiation. We applied a
multivariable Cox model to examine whether patient and hospital factors
were associated with in-hospital mortality.
Findings
Data
for 1035 patients with COVID-19 who received ECMO support were included
in this study. Of these, 67 (6%) remained hospitalised, 311 (30%) were
discharged home or to an acute rehabilitation centre, 101 (10%) were
discharged to a long-term acute care centre or unspecified location, 176
(17%) were discharged to another hospital, and 380 (37%) died. The
estimated cumulative incidence of in-hospital mortality 90 days after
the initiation of ECMO was 37·4% (95% CI 34·4–40·4). Mortality was 39%
(380 of 968) in patients with a final disposition of death or hospital
discharge. The use of ECMO for circulatory support was independently
associated with higher in-hospital mortality (hazard ratio 1·89, 95% CI
1·20–2·97). In the subset of patients with COVID-19 receiving
respiratory (venovenous) ECMO and characterised as having acute
respiratory distress syndrome, the estimated cumulative incidence of
in-hospital mortality 90 days after the initiation of ECMO was 38·0%
(95% CI 34·6–41·5).
Interpretation
In
patients with COVID-19 who received ECMO, both estimated mortality 90
days after ECMO and mortality in those with a final disposition of death
or discharge were less than 40%. These data from 213 hospitals
worldwide provide a generalisable estimate of ECMO mortality in the
setting of COVID-19.
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