| Summary: | Abstract Aim Although the obesity paradox is known for various diseases, including cancer and acute respiratory distress syndrome, little is known about veno‐venous extracorporeal membrane oxygenation (VV‐ECMO) in patients with coronavirus disease 2019 (COVID‐19). In this study, we aimed to investigate the association between body mass index (BMI) and prognosis in critical patients with COVID‐19 requiring VV‐ECMO. Methods We conducted a retrospective observational single‐center study at Yokohama City University Civic General Medical Center between March 2020 and October 2021. Participants were patients with COVID‐19 who required VV‐ECMO. They were classified into two groups: BMI ≤30 kg/m2 and >30 kg/m2. Results In total, 23 patients were included in the analysis, with a median BMI of 28.7 kg/m2. Overall, 22 patients were successfully weaned from the ECMO. When comparing the two groups, there was a trend toward fewer days from onset to ECMO induction in the BMI >30 kg/m2 group. Moreover, the two groups had a similar prognosis. There were no statistically significant differences in the number of days from onset to hospitalization or the duration of ECMO induction between the groups. Conclusion VV‐ECMO induction for patients with COVID‐19 may lead to earlier indications in patients with BMI >30 kg/m2 than in those with BMI ≤30 kg/m2.
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