For patients with severe acute respiratory distress syndrome (ARDS), receipt of ECMO(1) may improve survival. During the COVID-19 pandemic, the number of patients with COVID-19 referred for ECMO has exceeded the capacity of specialized centers to provide 
ECMO(2, 3). The outcomes of patients with COVID-19 who are eligible to receive ECMO, but do not because of limited health system capacity, have not been reported.