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High levels of Interleukin-10 (IL-10) are reported to be predictive of mortality in non-COVID ARDS patients receiving ECMO. In this study we evaluated if levels of biomarkers including IL-10 can predict mortality if measured prior to ECMO initiation in patients with COVID-19 ARDS. A total of sixteen patients with COVID-related ARDS undergoing treatment with ECMO were included in the pre-ECMO biomarker analysis, while samples from a total of 22 patients with post-ECMO samples were analyzed. Nine of sixteen patients with pre-ECMO samples (56%) survived to hospital discharge. There was no difference in baseline demographics between survivors and non-survivors. In univariate analysis, survivors had no difference in IL-10 levels prior to ECMO initiation although we identified several other biomarkers (Ang 1 and TNF-alpha with logistical regression, Mitochondrial DNA and IP-10 with Kaplan\u2013Meier analysis) that differed significantly between survivors and non-survivors. Moreover, as opposed to a prior study, area under the curve (AUC) analysis showed that IL-10 levels were not predictive of survival. We advise caution for utilizing a single biomarker as outcome predictor in this highly complex population with often long clinical courses despite our promising results.<\/jats:p>","DOI":"10.1038\/s41598-025-30047-9","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T20:46:41Z","timestamp":1764794801000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Biomarker studies to predict outcomes of patients with COVID-19 related acute respiratory distress syndrome measured pre and post initiation of veno venous extracorporeal membrane oxygenation"],"prefix":"10.1038","volume":"16","author":[{"given":"Mazen F.","family":"Odish","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hunter","family":"Gage","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael T. 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Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA 315, 788\u2013800 (2016).","journal-title":"JAMA"},{"key":"30047_CR2","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1007\/s00134-023-07050-7","volume":"49","author":"G Grasselli","year":"2023","unstructured":"Grasselli, G. et al. ESICM guidelines on acute respiratory distress syndrome: definition, phenotyping and respiratory support strategies. Intensive Care Med. 49, 727\u2013759 (2023).","journal-title":"Intensive Care Med."},{"key":"30047_CR3","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1164\/rccm.202311-2011ST","volume":"209","author":"N Qadir","year":"2024","unstructured":"Qadir, N. et al. An update on management of adult patients with acute respiratory distress syndrome: an official American Thoracic Society Clinical Practice Guideline. Am. J. Respir. Crit. 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Dr. Malhotra is funded by NIH. He reports income from Livanvoa, Powell Mansfield, Zoll, Eli Lilly and Sunrise. He is co-founder of Clairyon, a small startup related to predictive analytics in sepsis. Resmed gave a philanthropic donation to UCSD.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"IRB approval by the University of California, San Diego, Human Research Protections Program (#191464).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"IRB"}}],"article-number":"511"}}