Acute respiratory failure in COVID-19: is it “typical” ARDS?

Abstract

In December 2019, an outbreak of coronavirus disease 2019 (COVID-19) was identified in Wuhan, China. The World Health Organization (WHO) declared this outbreak a significant threat to international health. COVID-19 is highly infectious and can lead to fatal comorbidities especially acute respiratory distress syndrome (ARDS). Thus, fully understanding the characteristics of COVID-19-related ARDS is conducive to early identification and precise treatment. We aimed to describe the characteristics of COVID-19-related ARDS and to elucidate the differences from ARDS caused by other factors. COVID-19 mainly affected the respiratory system with minor damage to other organs. Injury to the alveolar epithelial cells was the main cause of COVID-19-related ARDS, and endothelial cells were less damaged with therefore less exudation. The clinical manifestations were relatively mild in some COVID-19 patients, which was inconsistent with the severity of laboratory and imaging findings. The onset time of COVID-19-related ARDS was 8–12 days, which was inconsistent with ARDS Berlin criteria, which defined a 1-week onset limit. Some of these patients might have a relatively normal lung compliance. The severity was redefined into three stages according to its specificity: mild, mild-moderate, and moderate-severe. HFNO can be safe in COVID-19-related ARDS patients, even in some moderate-severe patients. The more likely cause of death is severe respiratory failure. Thus, the timing of invasive mechanical ventilation is very important. The effects of corticosteroids in COVID-19-related ARDS patients were uncertain. We hope to help improve the prognosis of severe cases and reduce the mortality.

Cited by papers we hold 13

• A novel inhalable quercetin-alginate nanogel as a promising therapy for acute lung injury · 2022
  Not checked
• Gender and genetic factors impacting COVID-19 severity · 2021
  Not checked
• Comparison of characteristics and ventilatory course between coronavirus disease 2019 and Middle East respiratory syndrome patients with acute respiratory distress syndrome · 2021
  Not checked
• Low mortality of hospitalised patients with COVID-19 in a tertiary Danish hospital setting · 2021
  Not checked
• Role of JAK/STAT in Interstitial Lung Diseases; Molecular and Cellular Mechanisms · 2021
  No notice
• K18-hACE2 mice develop respiratory disease resembling severe COVID-19 · 2021
  No notice
• Deciphering the state of immune silence in fatal COVID-19 patients · 2021
  No notice
• Persistent Poor Health after COVID-19 Is Not Associated with Respiratory Complications or Initial Disease Severity · 2021
  No notice
• A physiological approach to understand the role of respiratory effort in the progression of lung injury in SARS-CoV-2 infection · 2020
  Not checked
• Mortality rates of patients with COVID-19 in the intensive care unit: a systematic review of the emerging literature · 2020
  No notice
• Autopsy findings in COVID-19-related deaths: a literature review · 2020
  No notice
• COVID-19: The Potential Treatment of Pulmonary Fibrosis Associated with SARS-CoV-2 Infection · 2020
  No notice
• SARS-CoV-2 spike protein binds to bacterial lipopolysaccharide and boosts proinflammatory activity · 2020
  No notice

Reads

A person counts once a day per paper. We keep no cookie and no address: a reader is a hash that changes every day. Any month under five reads shows no number.