INTRODUCTION: Severe respiratory failure is one of the most serious complications of coronavirus disease 2019 (COVID-19). In a small proportion of patients, mechanical ventilation fails to provide adequate oxygenation and extracorporeal membrane oxygenation (ECMO) is needed. The surviving individuals need long-term follow-up as it is not clear what their prognosis is. AIM: To provide a complex clinical picture of patients during follow-up exceeding one year after the ECMO therapy due to severe COVID-19. METHODS: All subjects involved in the study required ECMO in the acute stage of COVID-19. The survivors were followed-up for over one year at a specialized respiratory medical center. RESULTS: Of the 41 patients indicated for ECMO, 17 patients (64.7% males) survived. The average age of survivors was 47.8 years, and the average BMI was 34.7 kg·m-2. The duration of ECMO support was 9.4 days. A mild decrease in vital capacity (VC) and transfer factor (DLCO) was observed on the initial follow-up visit (82.1% and 60%, respectively). VC improved by 6.2% and by an additional 7.5% after 6 months and 1 year, respectively. DLCO improved by 21.1% after 6 months and remained stable after 1 year. Post-intensive care consequences included psychological problems and neurological impairment in 29% of patients; 64.7% of the survivors got vaccinated against SARS-CoV-2 within 12 months of hospitalization and 17.6% experienced reinfection with a mild course. CONCLUSION: The COVID-19 pandemic has significantly increased the need for ECMO. Patients' quality of life after ECMO is temporarily significantly reduced but most patients do not experience permanent disability.

Center for Digital Health Faculty of Medicine and Dentistry Palacky University Olomouc and University Hospital Olomouc 779 00 Olomouc Czech Republic

Department of Cardiac Surgery Faculty of Medicine and Dentistry Palacky University Olomouc and University Hospital Olomouc 779 00 Olomouc Czech Republic

Department of Psychiatry Faculty of Medicine and Dentistry Palacky University Olomouc and University Hospital Olomouc 779 00 Olomouc Czech Republic

Department of Psychological Sciences Faculty of Social Sciences and Health Care Constantine the Philosopher University in Nitra 949 74 Nitra Slovakia

Department of Psychotherapy Institute for Postgraduate Training in Health Care 100 05 Prague Czech Republic

Department of Respiratory Medicine and Tuberculosis Faculty of Medicine and Dentistry Masaryk University Brno and University Hospital Brno 601 77 Brno Czech Republic

Department of Respiratory Medicine and Tuberculosis Faculty of Medicine and Dentistry Palacky University Olomouc and University Hospital Olomouc 779 00 Olomouc Czech Republic

Department of Respiratory Medicine and Tuberculosis Faculty of Medicine P J Safarik University Kosice and University Hospital Kosice 040 01 Kosice Slovakia

Jessenia Inc Rehabilitation Hospital Beroun Akeso Holding 155 00 Prague Czech Republic

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