tetano
Editor, Senior Moderator
Int J Gen Med
. 2024 Jul 29:17:3337-3347.
doi: 10.2147/IJGM.S464892. eCollection 2024. COVID-19 Related Acute Respiratory Distress Syndrome versus Classical Acute Respiratory Distress Syndrome Patients: Inflammatory Biomarkers as Predictors of Mortality in Pulmonary Septic Shock
Cosmin Iosif Trebuian[SUP] 1 2 [/SUP], Daian Popa[SUP] 3 4 [/SUP], Florina Buleu[SUP] 5 6 [/SUP], Dumitru Sutoi[SUP] 1 5 [/SUP], Carmen Gabriela Williams[SUP] 3 [/SUP], Iulia Najette Crintea[SUP] 1 3 [/SUP], Raul Daniel Chioibas[SUP] 1 [/SUP], Aida Iancu[SUP] 7 [/SUP], Livia Ciolac[SUP] 8 [/SUP], Ovidiu Alexandru Mederle[SUP] 1 3 [/SUP]
Affiliations
Introduction and objectives: Coronavirus disease-2019 (COVID-19)-related severe acute respiratory distress syndrome (ARDS) differs pathophysiological from other pulmonary septic shock-related ARDS. Thus, we assessed whether all-cause in-hospital mortality differs for severe COVID-19-related and classical severe ARDS and which inflammatory biomarkers can predict mortality among these patients.
Material and methods: This single-center, retrospective, observational cohort study included pulmonary septic shock patients (n = 114) with COVID-19-related and classical severe ARDS admitted in the Intensive Care Unit.
Results: Patients with a mean age of 73 (IQR 62-82), predominantly male (63%), were divided into two groups based on outcomes: survivors (n = 50) and non-survivors (n = 64). COVID-19-related severe ARDS (n = 48) accounts for 75% of deaths. Present comorbidities like heart disease (p = 0.043), neurologic disorders (p = 0.018), and liver disease (p = 0.038) were associated with in-hospital mortality, as well. Regarding inflammatory biomarkers, the AUC/c-statistic was 0.656 (95% CI: 0.53-0.759) for leukocytes, 0.613 (95% CI: 0.509-0.717) C-reactive protein (CRP) and 0.651 (95% CI: 0.548-0.753) for procalcitonin in predicting all-cause in-hospital mortality among patients with pulmonary septic shock and severe ARDS.
Conclusion: Patients with pulmonary septic shock and with COVID-19-related severe ARDS had a higher incidence of in-hospital mortality than those with classical severe ARDS. The high value of leukocytes, C-reactive protein, and procalcitonin were predictive for all-cause in-hospital mortality in patients with pulmonary septic shock and ARDS. Infection with COVID-19 was an independent predictor of in-hospital mortality in the presence of ARDS.
Keywords: COVID-19; inflammatory biomarkers; outcomes; pulmonary septic shock; severe ARDS.
. 2024 Jul 29:17:3337-3347.
doi: 10.2147/IJGM.S464892. eCollection 2024. COVID-19 Related Acute Respiratory Distress Syndrome versus Classical Acute Respiratory Distress Syndrome Patients: Inflammatory Biomarkers as Predictors of Mortality in Pulmonary Septic Shock
Cosmin Iosif Trebuian[SUP] 1 2 [/SUP], Daian Popa[SUP] 3 4 [/SUP], Florina Buleu[SUP] 5 6 [/SUP], Dumitru Sutoi[SUP] 1 5 [/SUP], Carmen Gabriela Williams[SUP] 3 [/SUP], Iulia Najette Crintea[SUP] 1 3 [/SUP], Raul Daniel Chioibas[SUP] 1 [/SUP], Aida Iancu[SUP] 7 [/SUP], Livia Ciolac[SUP] 8 [/SUP], Ovidiu Alexandru Mederle[SUP] 1 3 [/SUP]
Affiliations
- PMID: 39100723
- PMCID: PMC11296509
- DOI: 10.2147/IJGM.S464892
Introduction and objectives: Coronavirus disease-2019 (COVID-19)-related severe acute respiratory distress syndrome (ARDS) differs pathophysiological from other pulmonary septic shock-related ARDS. Thus, we assessed whether all-cause in-hospital mortality differs for severe COVID-19-related and classical severe ARDS and which inflammatory biomarkers can predict mortality among these patients.
Material and methods: This single-center, retrospective, observational cohort study included pulmonary septic shock patients (n = 114) with COVID-19-related and classical severe ARDS admitted in the Intensive Care Unit.
Results: Patients with a mean age of 73 (IQR 62-82), predominantly male (63%), were divided into two groups based on outcomes: survivors (n = 50) and non-survivors (n = 64). COVID-19-related severe ARDS (n = 48) accounts for 75% of deaths. Present comorbidities like heart disease (p = 0.043), neurologic disorders (p = 0.018), and liver disease (p = 0.038) were associated with in-hospital mortality, as well. Regarding inflammatory biomarkers, the AUC/c-statistic was 0.656 (95% CI: 0.53-0.759) for leukocytes, 0.613 (95% CI: 0.509-0.717) C-reactive protein (CRP) and 0.651 (95% CI: 0.548-0.753) for procalcitonin in predicting all-cause in-hospital mortality among patients with pulmonary septic shock and severe ARDS.
Conclusion: Patients with pulmonary septic shock and with COVID-19-related severe ARDS had a higher incidence of in-hospital mortality than those with classical severe ARDS. The high value of leukocytes, C-reactive protein, and procalcitonin were predictive for all-cause in-hospital mortality in patients with pulmonary septic shock and ARDS. Infection with COVID-19 was an independent predictor of in-hospital mortality in the presence of ARDS.
Keywords: COVID-19; inflammatory biomarkers; outcomes; pulmonary septic shock; severe ARDS.