Multi-institutional Analysis of 200 COVID-19 Patients treated with ECMO:Outcomes and Trends

7/6 Late treatment study

Jacobs et al., The Annals of Thoracic Surgery, doi:10.1016/j.athoracsur.2021.06.026 (Peer Reviewed)
Multi-institutional Analysis of 200 COVID-19 Patients treated with ECMO:Outcomes and Trends

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Prospective study of 200 ECMO patients showing no significant difference in unadjusted results for HCQ treatment. Time based confounding is likely because HCQ became increasingly controversial and less used over the time covered (as shown in figure 4), while overall treatment protocols during this period improved dramatically, i.e., more control patients likely come later in the period when treatment protocols were greatly improved.

Jacobs et al., 7/6/2021, prospective, USA, North America, peer-reviewed, 14 authors.

risk of death, 6.6% lower, RR 0.93, p = 0.74, treatment 24 of 46 (52.2%), control 86 of 154 (55.8%).

This study is excluded in meta analysis: unadjusted results with no group details, substantial time varying confounding likely due to declining usage over the early period when overall treatment protocols improved dramatically.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. For an individual study the most serious outcome may have a smaller number of events and lower statistical signficance, however this provides the strongest evidence for the most serious outcomes when combining the results of many trials.

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