No Evidence of SARS-CoV-2 Spread Through ECMO or Dialysis Membranes

By Reuters Staff

June 18, 2020

NEW YORK (Reuters Health) - There is minimal risk of SARS-CoV-2 spreading through veno-venous extracorporeal membrane oxygenation (VV-ECMO) or continuous renal replacement therapy (CRRT), according to a French study believed to be the first to assess this potential risk.

"Our findings are reassuring regarding the risk of ICU professionals contamination when treating patients on VV-ECMO or CRRT," report Dr. Martin Dres of Sorbonne University and Pitie-Salpetriere Hospital, in Paris, and colleagues in the American Journal of Respiratory and Critical Care Medicine.

The clinicians evaluated 27 consecutive patients with severe SARS-CoV-2 infection admitted to three ICUs in Paris. All 27 patients were on mechanical ventilation and 25 were supported by VV-ECMO and eight by CRRT.

They investigated the risk of virus spreading within 48 hours after ECMO and CRRT initiation as the viral load, if present in plasma, is expected to progressively decline afterward, they point out.

SARS-CoV-2 RNA was present in lower-respiratory-tract samples from all patients and in plasma from 13 patients.

However, SARS-CoV-2 RNA was not detected in the membrane oxygenator gas outlet condensate, nor in the dialysis effluent, whether plasma RNA was positive or negative. Therefore, the estimated probability of a positive SARS-CoV-2 RNA in either location was zero, they report.

These findings "do not support the routine use of a viral filter on the exhaust of the commonly used polymethylpentene-based ECMO membrane lungs," the researchers say.

"Prevention and education of health care workers should therefore remain focused on limiting the risks of virus spreading during invasive respiratory procedures such as high flow oxygenation, mouth care, intubation or microbiological sampling of nasopharyngeal, tracheal or broncho-alveolar secretions," they conclude.

The study had no specific funding. Dr. Dres has received fees from Lungpacer Medical .

SOURCE: American Journal of Respiratory and Critical Care Medicine, online June 11, 2020.