key: cord-282216-ekzml19r authors: Huang, Shiqian; Xia, Haifa; Wu, Zhouyang; Zhao, Shuai; Yao, Shanglong; Luo, Huilin; Chen, Xiangdong title: Clinical data of early COVID-19 cases receiving extracorporeal membrane oxygenation in Wuhan, China date: 2020-09-14 journal: J Clin Anesth DOI: 10.1016/j.jclinane.2020.110044 sha: doc_id: 282216 cord_uid: ekzml19r • Shared early 3 cases on the application of ECMO in severely ill patients with COVID-19 in Wuhan, China; • Revealed the overall poor prognoses of these patients, probably related to the patients' age, underlying diseases, and the evolution of COVID-19, etc. • Proposed the particularly importance of grasping the indications of ECMO and selecting patients to clinicians, especially during the epidemic. can target the cytoplasmic components of invading lymphocytes to cause their destruction [4] . In addition, ECMO operation usually causes lymphopenia due to complex immune damage accompanied by activation of extracorporeal circuit. Considering the importance of lymphocyte filling for resistance to SARS-CoV-2, the decision of using ECMO should be made more cautiously in COVID-19 patients with significant lymphopenia [5] . In our report, Patient 1 died of sudden respiratory and circulatory failure and patient 2 died due to multiple organ dysfunction. Patient 3, without basic disease, his situation is gradually improving after active treatment. Indeed, ECMO can provide respiratory and cardiac support but cannot treat the underlying pathologic condition. In view of high mortality rate of severe COVID-19 patients, ECMO may have certain therapeutic benefits. However, the actual results indicated that the clinical benefits are limited, while the application may increase the medical burden, especially during the epidemic. Therefore, we must carefully choose the indications of ECMO. Early use of ECMO for younger patients without underlying diseases is the most recommended. ECMO is a complex and high-risk method that may lead to complications such as bleeding, infection, and limb ischemia. It should be done in centers with enough experience, quantity, and expertise to ensure safe use. Anyway, ECMO mustn't charge ahead to replace measures such as epidemic quarantine and prevention and control, oxygen inhalation, blood oxygen monitoring. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study Poor Survival With Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome (ARDS) Due to COVID-19): Pooled Analysis of Early Reports Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study Transcriptomic characteristics of bronchoalveolar lavage fluid and peripheral blood mononuclear cells in COVID-19 patients COVID-19, ECMO, and lymphopenia: a word of caution Not applicable.