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• ECMO has been used as a rescue therapy for severe respiratory failure and ARDS for years and ECMO should also be considered as a rescue therapy for COVID-19 with refractory hypoxemia despite lung-protective ventilation according to WHO. • Although the clinical trials of ECMO for COVID-19 are lacking, its use in COVID-19 might also offer promise based on the previous experience. • In the current situation of pandemic outbreak, many issues of ECMO use deserve our attention. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged since December 2019 in Wuhan city, and has quickly spread throughout China and other countries. To date, no specific treatment has been proven to be effective for SARS-CoV-2 infection. According to World Health Organization (WHO), management of coronavirus disease 19 (COVID-19) has mainly focused on infection prevention, case detection and monitoring, and supportive care. Given to the previous experience, extracorporeal membrane oxygenation (ECMO) has been proven to be an effective therapy in the treatment of respiratory failure or acute respiratory distress syndrome (ARDS). On the basis of similar principle, ECMO may be also an effective therapy in the treatment of severe COVID-19. In this study, we described and discussed the clinical outcomes of ECMO for ARDS patients, ECMO use for severe COVID-19 in China, the indications of ECMO use, and some important issues associated with ECMO. [ABSTRACT FROM AUTHOR]

• Most of the patients with COVID-19 who need to be admitted to hospital are older. • Older patients with COVID-19 had much more co-morbidity, complications and mortality. • Age, SOFA score, APACHEⅡ score, platelet count＜125 × 109/L, d-dimer, creatinine＞133 μmol/L, interleukin-6, and lung consolidation on admission were independent risk factors for severe cases among older patients with COVID-19. • More attention should be paid to older patients with COVID-19. Much of the previous research on COVID-19 was based on all population. But substantial numbers of severe episodes occur in older patients. There is a lack of data about COVID-19 in older adults. The aims of this study were to analyze the clinical characteristics of older adult patients with COVID-19. Retrospective study of older patients hospitalized with COVID-19 from February 1 st to March 31 st, 2020 was conducted in the Sino-French New City Branch of Tongjing Hospital in Wuhan, China. According to the degree of severity of COVID-19 during hospitalization, 312 older patients were divided into non-severe and severe cases. the mean age of the patients was 69.2 ± 7.3 years, and 47.4 % of patients had exposure history. 77.2 % of patients had a co-morbidity, with hypertension being the most common (57.1 %), followed by diabetes (38.8 %) and cardiovascular disease (29.8 %). Multivariable regression showed increasing odds of severe COVID-19 associated with age(OR 1.59, 95 %CI 1.13−2.08), SOFA score(OR 5.89, 95 %CI 3.48−7.96), APACHEⅡ score(OR 3.13, 95 %CI 1.85−5.62), platelet count＜125 × 109/L(OR 2.36, 95 %CI 1.03−4.14), d -dimer (OR 4.37, 95 %CI 2.58−7.16), creatinine＞133 μmol/L(OR 1.85, 95 %CI 1.12−3.04), interleukin-6(OR 4.32, 95 %CI 2.07−7.13), and lung consolidation(OR 1.94, 95 %CI 1.45−4.27) on admission. The most common complication was acute respiratory distress syndrome (35.6 %), followed by acute cardiac injury (33.0 %) and coagulation disorders (30.8 %). 91.7 % of patients were prescribed antiviral therapy, followed by immune globulin (52.9 %) and systemic glucocorticoids (43.6 %). 21.8 % of patients received invasive ventilation, 1.92 % for extracorporeal membrane oxygenation. The overall mortality was 6.73 %, and mortality of severe patients was 17.1 %, which was higher than non-severe patients (0.962 %). Older patients with COVID-19 had much more co-morbidity, complications and mortality. More attention should be paid to older patients with COVID-19. [ABSTRACT FROM AUTHOR]