Patients with coronavirus disease of 2019 (COVID-19) may present with a wide range of symptoms ranging from asymptomatic to critically ill. Approximately 10-14% of patients require hospitalization. Those individuals requiring hospitalization can deteriorate rapidly with worsening hypoxemia or new-onset pneumonia, resulting in 20-30% of patients developing acute respiratory distress syndrome (ARDS).

When refractory to medical management, severe ARDS secondary to other illnesses has been successfully treated with extracorporeal membrane oxygenation (ECMO). We completed a comprehensive literature review of ECMO utilization for patients with severe COVID-19 who were unresponsive to critical care management. Of the 1419 patients with a reported diagnosis of COVID-19-related ARDS requiring ECMO therapy, 53.6% were discharged alive, 8.4% remained on ECMO in the intensive care unit, and 43.0% are deceased. These results are similar to the discharge rate of 60% for patients with non-COVID-related ARDS treated with ECMO. Data reported by the Extracorporeal Life Support Organization notes that 49% of patients with COVID-19 ARDS were discharged alive, 38% of whom were discharged home or to a long-term facility, and 11% were discharged to another hospital. In summary, using ECMO to treat patients with severe ARDS unresponsive to critical care management yields similar results in both non-COVID and COVID-related ARDS.