Ventilatory variables and computed tomography features in COVID-19 ARDS and non–COVID-19-related ARDS: a prospective observational cohort study
Abstract Background This study compared the ventilatory variables and computed tomography (CT) features of patients with coronavirus disease 2019 (COVID-19) versus those of patients with pulmonary non–COVID-19-related acute respiratory distress syndrome (ARDS) during the early phase of ARDS. Methods...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
|
| Series: | European Journal of Medical Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40001-025-02303-1 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832571855583576064 |
|---|---|
| author | Li-Chung Chiu Hsin-Hsien Li Yu-Hsiang Juan How-Wen Ko Scott Chih-Hsi Kuo Chung-Shu Lee Tien-Ming Chan Yu-Jr Lin Li-Pang Chuang Han-Chung Hu Kuo-Chin Kao Ping-Chih Hsu |
| author_facet | Li-Chung Chiu Hsin-Hsien Li Yu-Hsiang Juan How-Wen Ko Scott Chih-Hsi Kuo Chung-Shu Lee Tien-Ming Chan Yu-Jr Lin Li-Pang Chuang Han-Chung Hu Kuo-Chin Kao Ping-Chih Hsu |
| author_sort | Li-Chung Chiu |
| collection | DOAJ |
| description | Abstract Background This study compared the ventilatory variables and computed tomography (CT) features of patients with coronavirus disease 2019 (COVID-19) versus those of patients with pulmonary non–COVID-19-related acute respiratory distress syndrome (ARDS) during the early phase of ARDS. Methods This prospective, observational cohort study of ARDS patients in Taiwan was performed between February 2017 and June 2018 as well as between October 2020 and January 2024. Analysis was performed on clinical characteristics, including consecutive ventilatory variables during the first week after ARDS diagnosis. Analysis was also performed on CT scans obtained within one week after ARDS onset. Results A total of 222 ARDS patients were divided into a COVID-19 ARDS group (n = 44; 19.8%) and a non–COVID-19 group (all pulmonary origin) (n = 178; 80.2%). No significant difference was observed between the two groups in terms of all-cause hospital mortality (38.6% versus 47.8%, p = 0.277). Pulmonary non–COVID-19 patients presented higher values for mechanical power (MP), MP normalized to predicted body weight (MP/PBW), MP normalized to compliance (MP/compliance), ventilatory ratio (VR), peak inspiratory pressure (Ppeak), and dynamic driving pressure (∆P) as well as lower dynamic compliance from day 1 to day 7 after ARDS onset. In both groups, non-survivors exceeded survivors and presented higher values for MP, MP/PBW, MP/compliance, VR, Ppeak, and dynamic ∆P with lower dynamic compliance from day 1 to day 7 after ARDS onset. The CT severity score for each of the five lung lobes and total CT scores were all significantly higher in the non–COVID-19 group (all p < 0.05). Multivariable logistic regression models revealed that Sequential Organ Failure Assessment (SOFA) score was independently associated with mortality in the COVID-19 group. In the non–COVID-19 group, body mass index, immunocompromised status, SOFA score, MP/PBW and total CT severity scores were independently associated with mortality. Conclusions In the early course of ARDS, physicians should be aware of the distinctions between COVID-19-related ARDS and non–COVID-19-related ARDS in terms of ventilatory variables and CT imaging presentations. It is also important to tailor the mechanical ventilation settings according to these distinct subsets of ARDS. |
| format | Article |
| id | doaj-art-599d8030a5b9472098aef535562cfb79 |
| institution | Kabale University |
| issn | 2047-783X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj-art-599d8030a5b9472098aef535562cfb792025-02-02T12:13:58ZengBMCEuropean Journal of Medical Research2047-783X2025-01-0130111310.1186/s40001-025-02303-1Ventilatory variables and computed tomography features in COVID-19 ARDS and non–COVID-19-related ARDS: a prospective observational cohort studyLi-Chung Chiu0Hsin-Hsien Li1Yu-Hsiang Juan2How-Wen Ko3Scott Chih-Hsi Kuo4Chung-Shu Lee5Tien-Ming Chan6Yu-Jr Lin7Li-Pang Chuang8Han-Chung Hu9Kuo-Chin Kao10Ping-Chih Hsu11Department of Thoracic Medicine, Chang Gung Memorial Hospital, Linkou BranchDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Linkou BranchCollege of Medicine, Chang Gung UniversityDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Linkou BranchDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Linkou BranchDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Linkou BranchCollege of Medicine, Chang Gung UniversityResearch Services Center for Health Information, Chang Gung UniversityDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Linkou BranchDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Linkou BranchDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Linkou BranchDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Linkou BranchAbstract Background This study compared the ventilatory variables and computed tomography (CT) features of patients with coronavirus disease 2019 (COVID-19) versus those of patients with pulmonary non–COVID-19-related acute respiratory distress syndrome (ARDS) during the early phase of ARDS. Methods This prospective, observational cohort study of ARDS patients in Taiwan was performed between February 2017 and June 2018 as well as between October 2020 and January 2024. Analysis was performed on clinical characteristics, including consecutive ventilatory variables during the first week after ARDS diagnosis. Analysis was also performed on CT scans obtained within one week after ARDS onset. Results A total of 222 ARDS patients were divided into a COVID-19 ARDS group (n = 44; 19.8%) and a non–COVID-19 group (all pulmonary origin) (n = 178; 80.2%). No significant difference was observed between the two groups in terms of all-cause hospital mortality (38.6% versus 47.8%, p = 0.277). Pulmonary non–COVID-19 patients presented higher values for mechanical power (MP), MP normalized to predicted body weight (MP/PBW), MP normalized to compliance (MP/compliance), ventilatory ratio (VR), peak inspiratory pressure (Ppeak), and dynamic driving pressure (∆P) as well as lower dynamic compliance from day 1 to day 7 after ARDS onset. In both groups, non-survivors exceeded survivors and presented higher values for MP, MP/PBW, MP/compliance, VR, Ppeak, and dynamic ∆P with lower dynamic compliance from day 1 to day 7 after ARDS onset. The CT severity score for each of the five lung lobes and total CT scores were all significantly higher in the non–COVID-19 group (all p < 0.05). Multivariable logistic regression models revealed that Sequential Organ Failure Assessment (SOFA) score was independently associated with mortality in the COVID-19 group. In the non–COVID-19 group, body mass index, immunocompromised status, SOFA score, MP/PBW and total CT severity scores were independently associated with mortality. Conclusions In the early course of ARDS, physicians should be aware of the distinctions between COVID-19-related ARDS and non–COVID-19-related ARDS in terms of ventilatory variables and CT imaging presentations. It is also important to tailor the mechanical ventilation settings according to these distinct subsets of ARDS.https://doi.org/10.1186/s40001-025-02303-1COVID-19ARDSMechanical ventilationVentilatory ratioComplianceMechanical power |
| spellingShingle | Li-Chung Chiu Hsin-Hsien Li Yu-Hsiang Juan How-Wen Ko Scott Chih-Hsi Kuo Chung-Shu Lee Tien-Ming Chan Yu-Jr Lin Li-Pang Chuang Han-Chung Hu Kuo-Chin Kao Ping-Chih Hsu Ventilatory variables and computed tomography features in COVID-19 ARDS and non–COVID-19-related ARDS: a prospective observational cohort study European Journal of Medical Research COVID-19 ARDS Mechanical ventilation Ventilatory ratio Compliance Mechanical power |
| title | Ventilatory variables and computed tomography features in COVID-19 ARDS and non–COVID-19-related ARDS: a prospective observational cohort study |
| title_full | Ventilatory variables and computed tomography features in COVID-19 ARDS and non–COVID-19-related ARDS: a prospective observational cohort study |
| title_fullStr | Ventilatory variables and computed tomography features in COVID-19 ARDS and non–COVID-19-related ARDS: a prospective observational cohort study |
| title_full_unstemmed | Ventilatory variables and computed tomography features in COVID-19 ARDS and non–COVID-19-related ARDS: a prospective observational cohort study |
| title_short | Ventilatory variables and computed tomography features in COVID-19 ARDS and non–COVID-19-related ARDS: a prospective observational cohort study |
| title_sort | ventilatory variables and computed tomography features in covid 19 ards and non covid 19 related ards a prospective observational cohort study |
| topic | COVID-19 ARDS Mechanical ventilation Ventilatory ratio Compliance Mechanical power |
| url | https://doi.org/10.1186/s40001-025-02303-1 |
| work_keys_str_mv | AT lichungchiu ventilatoryvariablesandcomputedtomographyfeaturesincovid19ardsandnoncovid19relatedardsaprospectiveobservationalcohortstudy AT hsinhsienli ventilatoryvariablesandcomputedtomographyfeaturesincovid19ardsandnoncovid19relatedardsaprospectiveobservationalcohortstudy AT yuhsiangjuan ventilatoryvariablesandcomputedtomographyfeaturesincovid19ardsandnoncovid19relatedardsaprospectiveobservationalcohortstudy AT howwenko ventilatoryvariablesandcomputedtomographyfeaturesincovid19ardsandnoncovid19relatedardsaprospectiveobservationalcohortstudy AT scottchihhsikuo ventilatoryvariablesandcomputedtomographyfeaturesincovid19ardsandnoncovid19relatedardsaprospectiveobservationalcohortstudy AT chungshulee ventilatoryvariablesandcomputedtomographyfeaturesincovid19ardsandnoncovid19relatedardsaprospectiveobservationalcohortstudy AT tienmingchan ventilatoryvariablesandcomputedtomographyfeaturesincovid19ardsandnoncovid19relatedardsaprospectiveobservationalcohortstudy AT yujrlin ventilatoryvariablesandcomputedtomographyfeaturesincovid19ardsandnoncovid19relatedardsaprospectiveobservationalcohortstudy AT lipangchuang ventilatoryvariablesandcomputedtomographyfeaturesincovid19ardsandnoncovid19relatedardsaprospectiveobservationalcohortstudy AT hanchunghu ventilatoryvariablesandcomputedtomographyfeaturesincovid19ardsandnoncovid19relatedardsaprospectiveobservationalcohortstudy AT kuochinkao ventilatoryvariablesandcomputedtomographyfeaturesincovid19ardsandnoncovid19relatedardsaprospectiveobservationalcohortstudy AT pingchihhsu ventilatoryvariablesandcomputedtomographyfeaturesincovid19ardsandnoncovid19relatedardsaprospectiveobservationalcohortstudy |