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Background: Critically ill patients with COVID-19 infection on extracorporeal membrane oxygenation (ECMO) face high morbidity and mortality. Palliative care consultation may benefit these patients and their families. Prior to the pandemic, our institution implemented a policy of automatic palliative care consultation for all patients on ECMO due to the high mortality, medical complexity, and psychosocial distress associated with these cases. Objectives: The main objective was to describe the role of the palliative care team for patients on ECMO for COVID-19 infection. The secondary objective was to describe the clinical outcomes for this cohort. Design: Case series. Settings/Subjects: All patients age 18 or older infected by the novel coronavirus who required cannulation on ECMO from March through July of 2020, at an urban, academic medical center in the United States. Inter-disciplinary palliative care consultation occurred for all patients. Results: Twenty-three patients (median age 43 years [range 28-64], mean body mass index 34.9 kg/m2 [SD 9.2], 65% Hispanic ethnicity) were cannulated on ECMO. Eleven patients died during the hospitalization (48%). Patients older than 50 years of age demonstrated a trend toward increased odds of death compared to those younger than 50 years of age (OR 9.1, P = 0.07). Patients received an average of 6.8 (SD 3.7) palliative clinical encounters across all disciplines. The actions provided by the palliative care team included psychosocial support and counseling, determination of surrogate decision maker (for 100% of patients), pain management (83%), and non-pain symptom management (83%). Conclusions: Here, we present one of the first studies describing the patient characteristics, outcomes, and palliative care actions for critically ill patients with COVID-19 on ECMO. Almost half of the patients in this cohort died during their hospitalization. Given the high morbidity and mortality of this condition, we recommend involvement of palliative care for patients/families with COVID-19 infection who are on ECMO. The impact of palliative care on patient and family outcomes, such as symptom control, satisfaction with communication, rates of anxiety, and grief experience merits further investigation.

SESSION TITLE: Late-breaking Abstracts SESSION TYPE: Original Investigations PRESENTED ON: October 18-21, 2020 PURPOSE: To generate a preliminary version of a novel risk score to predict the need for invasive mechanical ventilation (MV) in patients with COVID-19 METHODS: Retrospective analysis of patients >18 years-of-age with laboratory-confirmed COVID-19 admitted between March 15-April 15, 2020 to a tertiary-care center Demographic, laboratory, clinical, and outcome information were recorded, using a standard data-collection format RESULTS: The cohort included 265 subjects (mean age 59 3 ±16 4 years, 55 1% male) and 54 (20 4%) required invasive MV Significant between-group univariate results, based on the need for invasive MV, were used in multiple-regression analysis Admission heart rate (HR) (OR 1 032 [CI 1 013-1 015];p101 5 BPM (AUC 0 686, 68 5% sensitivity & 66 4% specificity) and S/F ratio