Abstract:Objective To investigate the efficacy and timing of the extracorporeal membrane oxygenation (ECMO) in patients with critical COVID-19. Methods The patients who diagnosed with critical COVID-19 and treated with ECMO in the isolation ward of Emergency Center,Zhongnan Hospital of Wuhan University from January 1st,2020 to March 1st,2020 were selected.The basic information,epidemiology,clinical manifestation,laboratory examination,imaging data,routine treatment,ECMO application and clinical outcome were collected and analyzed. Results All the 5 patients with ECMO support had a history of epidemiological exposure,including 4 males and 1 female.All the patients entered the isolation ward with fever.The body temperature of 4 patients was over 38.5 ℃.Severe acute respiratory distress syndrome (ARDS) was found in 3 patients,all of them showed decreased lymphocyte and increased procalcitonin.CT images of the chest showed multiple subpleural ground glass shadows on both sides.In addition to ECMO support,all patients received oxygen therapy,antiviral,empirical antibiotics and glucocorticoid therapy.Three patients survived,and their RESP score supported by ECMO was 4-7,and the time from severe ARDS to ECMO application was less than or equal to 10 hours.Two patients died,one of them died of cerebral hemorrhage,RESP score was 4 points,one died of pneumothorax and empyema combined with multiple organ failure,RESP score was -1 point;the time from severe ARDS to ECMO application was 185 h and 576 h respectively. Conclusions ECMO is effective in the treatment of critical COVID-19 patients.The early application of ECMO after severe ARDS can improve the prognosis of patients.