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

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...

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Veröffentlicht in:Critical care (London, England) Jg. 24; H. 1; S. 198 - 5
Hauptverfasser: Li, Xu, Ma, Xiaochun
Format: Journal Article
Sprache:Englisch
Veröffentlicht: London BioMed Central 06.05.2020
BioMed Central Ltd
Springer Nature B.V
BMC
Schlagworte:
Acute Lung Injury - diagnostic imaging
Acute Lung Injury - epidemiology
Acute Lung Injury - therapy
Acute respiratory distress syndrome
Adult respiratory distress syndrome
Berlin criteria
Betacoronavirus
Cardiac arrhythmia
China
Classification
Coronavirus
Coronavirus Infections - diagnosis
Coronavirus Infections - epidemiology
Coronavirus Infections - therapy
Coronaviruses
COVID-19
Creatine Kinase - blood
Critical care
Critical Care Medicine
Emergency Medicine
Female
Germany
Health aspects
Humans
Immunomodulators
Intensive
Intubation
L-Lactate Dehydrogenase - blood
Male
Medicine
Medicine & Public Health
Mortality
Pandemics
Pneumonia, Viral - diagnosis
Pneumonia, Viral - epidemiology
Pneumonia, Viral - therapy
Radiography
Respiration, Artificial
Respiratory Distress Syndrome - classification
Respiratory Distress Syndrome - diagnostic imaging
Respiratory Distress Syndrome - epidemiology
Respiratory Distress Syndrome - therapy
Respiratory failure
Respiratory insufficiency
Respiratory system
Review
SARS-CoV-2
Severe acute respiratory syndrome
Severe acute respiratory syndrome coronavirus 2
Severity of Illness Index
Time Factors
United Kingdom
Ventilators
United Kingdom
China
Germany
COVID-19
Acute respiratory distress syndrome
Coronavirus
Berlin criteria
ISSN:1364-8535, 1466-609X, 1364-8535, 1466-609X, 1366-609X
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Zusammenfassung: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.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:1364-8535
1466-609X
1364-8535
1466-609X
1366-609X
DOI:10.1186/s13054-020-02911-9