they received ecmo half of these were actually started on ecmo likely by the receiving hospitals team before they were transferred this reinforces the importance of communication between ecmocapable hospitals and nonecmo hospitals that might have covid19 patients who could benefit from ecmo the new study could also help identify which patients will benefit most if they are placed on ecmo our findings also show that mortality risk rises significantly with patient age and that those who are immunocompromised have acute kidney injuries worse ventilator outcomes or covid19related cardiac arrests are less likely to survive continues barbaro who chairs elsos covid19 registry committee and provides ecmo care as a pediatric intensive care physician at ums cs mott childrens hospital those who need ecmo to replace cardiac function as well as lung function also did worse all of this knowledge can help centres and families understand what patients might face if they are placed on ecmo the lack of reliable information early in the pandemic hampered our ability to understand the role of ecmo for covid19 says cosenior author daniel brodie md of new york presbyterian hospital the results of this largescale international registry study while hardly definitive evidence provide a realworld understanding of the potential for ecmo to save lives in a highly selected population of covid19 patients brodie shares senior authorship with roberto lorusso md of the maastricht university medical center in the netherlands and alain combes md of sorbonne university in parisa robust statistical approach because the elso database does not track what happens to patients once they are discharged to home other hospitals and longterm acute care or rehabilitation facilities the study used a statistical approach based on inhospital mortality up to 90 days after the patient was put ecmo this also allows the team to account for the 67 patients who were still in the hospital as of august 5 whether they were still on ecmo in the icu or in stepdown units philip boonstra phd of the um school of public health helped design the study using a competing risk approach based on his experience handling the statistical design and analysis of longterm data from clinical trials for cancer we used 90day inhospital mortality because this is the highestrisk period and because it allows us to use the information we have to the fullest even if we dont know the final outcome for every patient he says having data through august when only a small number of the patients in the study remained in the hospital was important though data are missing on a small number of patients and even though patients who were discharged to their homes or a rehabilitation facility will likely have a long recovery ahead after the intensive level of care involved in ecmo they are likely to survive based on past data however the fate of those who went to ltac facilities which provide longterm care at a nearicu level is less certainmore about the study and