Acute Respiratory Distress Syndrome in Confirmed and Suspected Cases of Covid-19:A Cross Sectional Study

2021 ◽  
Vol 15 (5) ◽  
pp. 1176-1179
Author(s):  
F. Sadiq ◽  
K. Ayoub ◽  
F. Riaz ◽  
S. Razzaq ◽  
A. Farooq ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Inflammatory Markers ◽  
Distress Syndrome ◽  
Shortness Of Breath ◽  
Cross Sectional ◽  
X Ray ◽  
Bilateral Lung ◽  
D Dimer

Aim: To observe the frequency, severity and susceptibility to develop the severe symptoms of acute respiratory distress syndrome in confirmed and suspected cases of COVID-19. Study design: Cross sectional observational study. Place and duration of study: Lahore General Hospital, Lahore. Methodology: After Ethical Committee approval in 164 patients of confirmed or suspected COVID-19 who underwent the complication of ARDS were enrolled, admitted in department of Medicine and Intensive Care Unit at Lahore General Hospital, Lahore. After taking consent we studied different features in these patients like age, gender, comorbidities, symptoms, their radiological findings, SATS, PO2/FIO2 ratio, serum ferritin, CRP, LDH and d-dimer levels, and results were analyzed. Result: Out of 164 patients, 103 were COVID-19 positive. Mostly middle aged to old males developed the complications of ARDS. The most common symptoms observed were fever, cough and shortness of breath. Most common comorbidities present in the patients were diabetes and hypertension. HRCT was done in severe cases and 25 out of 35 patients had either unilateral or bilateral lung opacities. On chest X-ray 76% patients had bilateral lung infiltrates and 12% patients were having unilateral infiltrates. Inflammatory markers such as CRP, serum LDH, serum Ferritin, D-dimers were raised in most of the patients who developed moderate to severe ARDS. Conclusion: We concluded that the middle aged to old males with comorbidities like diabetes and hypertension are more likely to undergo ARDS. They can present with shortness of breath alone or in combination with fever and cough. Their X-ray usually showed bilateral patchy infiltrates and their ferritin, CRP, LDH and d- dimer levels are usually high. Keywords: ARDS, COVID-19, Inflammatory Markers

scholarly journals Clinical characteristics of Egyptian male patients with COVID‐19 acute respiratory distress syndrome

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249346
Author(s):  
Ahmed S. Doghish ◽  
Walid F. Elkhatib ◽  
Essam A. Hassan ◽  
Ahmed F. Elkhateeb ◽  
Eman E. Mahmoud ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Clinical Characteristics ◽  
Distress Syndrome ◽  
Monocyte Count ◽  
Reactive Protein ◽  
Link Type ◽  
Male Patients ◽  
D Dimer

Background Coronavirus disease 2019 (COVID-19) is a serious illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and in severe cases associated with acute respiratory distress syndrome (ARDS). Objective To describe the clinical characteristics of patients with ARDS-COVID-19. Materials and methods This study involved 197 male Egyptian participants, among them111 COVID-19 patients presented with ARDS, 60 COVID-19 patients presented with non-ARDS, and 26 Non-COVID-19 patients. We reported the analysis results of clinical and laboratory information, including blood routine tests, blood biochemistry parameters [aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine and C‐reactive protein (CRP)], thrombotic activity (D‐dimer) and serum ferritin and lactate dehydrogenase (LDH). Results The levels of hemoglobin, AST, creatinine, monocyte count, monocyte %, RBC count, TLC, and platelet count were not significantly different among the groups. The lymphopenia and increased CRP, ALT, D-dimer, ferritin, and LDH were observed in patients with ARDS-COVID-19. Conclusion COVID-19 patients with ARDS presented with lymphopenia, increased thrombotic activity, increased CRP, LDH, and ferritin levels. The results revealed that CRP, D-dimer, LDH levels, and lymphopenia have a significant association with the COVID-19 severity and can be used as biomarkers to predict the disease severity.

scholarly journals Effectiveness and Outcome of Methylprednisolone versus Hydrocortisone in Treatment of Acute Respiratory Distress Syndrome(ARDS)

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
S A S Elbrassi ◽  
K M Maghawry ◽  
R M M Ali ◽  
R H Abdelhafiez
Keyword(s):  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Critically Ill ◽  
Low Dose ◽  
Distress Syndrome ◽  
Patient Discharge ◽  
P Value ◽  
D Dimer

Abstract Introduction Acute respiratory distress syndrome (ARDS) is the clinical manifestation of severe acute lung injury. It is characterized by dyspnea, profound hypoxemia, diffuse bilateral infiltrates secondary to non-cardiogenic pulmonary edema on chest radiography, and decreased lung compliance and systemic inflammations are the pathophysiologic hallmarks of this syndrome and the use of low-dose corticosteroids was associated with improved mortality and morbidity outcomes without increased adverse reactions. Aim The aim of this study is to compare the outcome and effectiveness of hydrocortisone to methylprednisolone in treatment of acute respiratory distress syndrome in critically ill adult patients. Patients The current study was performed as a randomized prospective observational study on critically ill patients at age between 18-85 years. Methods Critically ill patients diagnosis with ARDS were managed with standard treatment in addition to methylprednisolone 1mg/kg as loading dose followed by an infusion of 1 mg/kg/d for one week and then gradual tapering over two weeks as following (0.5 mg/kg/d in the second week and 0.25 mg/kg/d in the third week) or hydrocortisone 50mg given every six hours for one week. Results Mean age of included patients was 65.20 years with mean BMI 28.14 kg/m2, in our result the PaO2/FIO2 ratio revealed significant statistically increase in methylprednisolone-treated patients compared to hydrocortisone -treated patients (160.49±54.75, 138.55±60.99, P value 0.029), Regarding the inflammatory marker the results of the plasma level of C-reactive protein and d-dimer showed significant difference between both group, the result of SOFA score showed no significant different from day 1 to day 3 (8.25±3.11, 8.29±2.29 P value 0.980). But with the beginning of the fifth day was observed significant change in the results, methylprednisolone-treated patients compared to hydrocortisone -treated patients (8.28±3.84, 9.8±4.23, P value 0.036), Regarding to ICU length of stay and decrease duration of mechanical ventilation, the results of our study didn’t show significant different among both groups. The two groups showed a decrease in the time spended on the mechanical ventilation and the stay in the ICU before day7. According to the number of patient discharge from ICU at day 7 and the number of extubated patient at day 7, the results of our study didn’t show significant different among both groups. Conclusion Despite the both applied drug doses show improvement regarding the finial total outcome. However, Methylprednisolone showed superior benefit compare to Hydrocortisone in improvement of PaO2/FiO2 ratio, suppress systemic inflammation (CRP and D- dimer), increase extubated patient before day 7, increase number of patient discharge from ICU before day 7, reduction of SOFA score and hospital morality rate. Recommendations The study recommends to use of low dose methylprednisolone superior to hydrocortisone in treatment of ARDS. But, still more researches are need.

scholarly journals Lung ultrasound assessment of acute respiratory distress syndrome caused by coronavirus disease 2019: An observational study

2020 ◽  
pp. 102490792096932
Author(s):  
Ruiting Li ◽  
Hong Liu ◽  
Hong Qi ◽  
Yin Yuan ◽  
Xiaojing Zou ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Observational Study ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Characteristic Analysis ◽  
X Ray ◽  
Chest X Ray

Background: An outbreak of coronavirus disease 2019 (COVID-19) took place in Wuhan, China, by the end of 2019, and the disease continues to spread all over the world. The number of patients is increasing rapidly, a large number of infected patients is critically ill, and the mortality is high. However, information on COVID-19 patients is limited, and its clinical characteristics have not been fully studied. Objectives: To compare the performances of point-of-care lung ultrasound (LUS) and bedside chest X-ray in assessing the condition of COVID-19 patients with acute respiratory distress syndrome (ARDS). Methods: This observational study enrolled 42 COVID-19 patients with ARDS who were admitted to the Department of Critical Care Medicine of the Wuhan Union Hospital from February to April 2020. The point-of-care LUS characteristics of the COVID-19 patients with ARDS were summarized, and the performances of LUS and bedside chest X-ray in assessing the patient’s condition were compared. Results: Most of the 42 patients were elderly individuals with chronic clinical diseases. The proportion of patients older than 60 years old was 85.7%. All patients were given invasive mechanical ventilation; eight (19.0%) of them received venovenous extracorporeal membrane oxygenation support. LUS has evident advantages in detecting lung consolidation, patchy shadows, and pleural thickening, and pleural line changes in particular. The receiver operating characteristic analysis indicated that the sensitivity, Youden index, and kappa value for detecting COVID-19 patients with ARDS were higher for LUS than the chest X-ray. Conclusion: LUS has better diagnostic accuracy and sensitivity in COVID-19 patients with ARDS than the chest X-ray.

scholarly journals Gangguan Koagulasi Pada Pasien Covid-19

2021 ◽  
Vol 2 (2) ◽  
pp. 63-72
Author(s):  
TUTIK HARJIANTI
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Venous Thromboembolism ◽  
Middle East ◽  
Severe Acute Respiratory Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Middle East Respiratory Syndrome ◽  
D Dimer

Severe acute respiratory syndrome coronavirus (SARS-CoV-2) merupakan famili dari coronavirus, sudah dua kali menyababkan kejadian luar biasa  yaitu di tahun 2003 dengan SARS (Severe Acute Respiratory Syndrome) dan tahun 2012 dengan penyakit  MERS (Middle East Respiratory Syndrome). Pada tahun 2019 SARS-CoV-2 telah menyebabkan pandemi global kembali. Pertama kali diidentifikasi di Wuhan, Cina. Dan telah menyebar ke seluruh negara dengan jumlah kasus yang terus meningkat secara eksponensial diseluruh dunia. Pada Maret 2020 oleh WHO dinyatakan pandemic. (Covid-19), menyebabkan pneumonia dan beberapa kondisi dapat terjadi Acute Respiratory Distress Syndrome (ARDS) serta beberapa manifestasi ekstra paru, seperti kardiovaskular, saluran cerna, ginjal ,hematologi, sekuele akibat trombosis dan progresifitas disfungsi organ.1 Prognosis pada pasien Covid-19 salah satu tanda ,gejalanya adalah terjadinya gangguan koagulasi, yang ditandai dengan meningkatnya nilai D dimer sebagai tanda awal kondisi thrombosis dan  salah satunya dapat bermanifestasi sebagai Venous Thromboembolism (VTE). Pada pasien dengan Covid-19, kondisi koagulopati adalah salah satu kunci dan tanda persisten yang terkait dengan outcome yang buruk.1,2   

scholarly journals Acute respiratory distress syndrome, metabolic acidosis, and respiratory acidosis associated with citalopram overdose

2013 ◽  
Vol 2 (5) ◽  
pp. 24
Author(s):  
Hawa Edriss ◽  
Marie Pfarr
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Metabolic Acidosis ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Respiratory Acidosis ◽  
Altered Mental Status ◽  
Cardiac Biomarkers ◽  
X Ray ◽  
Chest X Ray

We report a 53-year-old man who ingested 2400 mg of citalopram and presented to the emergency department three hours post-ingestion with altered mental status, somnolence, and a blood pressure of 67/45 mmHg. He failed to respond to three boluses of normal saline (1000 ml each) and required vasopressors. The patient developed serotonin syndrome with hyper-reflexia, rigidity, and ankle myoclonus. He had a tonic-clonic seizure in the ER requiring intravenous lorazepam and phenytoin. An ECG showed QT prolongation. Chest x-ray on presentation was normal. Within 32 hours the patient developed acute respiratory distress, hypoxemia, a wide A-a gradient, PaO2/FiO2< 200, and chest x-ray changes compatible with acute respiratory distress syndrome (ARDS). He had normal central venous pressures, normal cardiac biomarkers, normal systolic and diastolic functions on echocardiography, and no acute ST/T wave changes. His ABG showed a metabolic acidosis and a respiratory acidosis. The patient required intubation and ventilation. Citalopram has been associated with seizures and ECG abnormalities after overdoses. The respiratory complications and metabolic acidosis have been reported only a few times in the literature.  We are reporting the second case of ARDS and the fifth case of metabolic acidosis due to citalopram overdose and suggest that the metabolic acidemia is explained by propionic acid. The respiratory acidosis seen in this patient has not been reported previously.

scholarly journals Neutrophil extracellular traps persist at high levels in the lower respiratory tract of critically ill COVID-19 patients

2021 ◽  
Author(s):  
Werner J D Ouwendijk ◽  
Matthijs P Raadsen ◽  
Jeroen J A van Kampen ◽  
Robert M Verdijk ◽  
Jan H von der Thusen ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Tract ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Critically Ill ◽  
Inflammatory Markers ◽  
Lower Respiratory Tract ◽  
Distress Syndrome ◽  
Neutrophil Extracellular Traps ◽  
Extracellular Traps

Abstract SARS-CoV-2 induced lower respiratory tract (LRT) disease can deteriorate to acute respiratory distress syndrome (ARDS). Because the release of neutrophil extracellular traps (NETs) is implicated in ARDS pathogenesis, we investigated the presence of NETs and correlates of pathogenesis in blood and LRT samples of critically ill COVID-19 patients. Plasma NET levels peaked early after ICU admission and correlated with SARS-CoV-2 RNA load in sputum and levels of neutrophil-recruiting chemokines and inflammatory markers in plasma. Baseline plasma NET quantity correlated with disease severity, but was not associated with soluble markers of thrombosis nor with development of thrombosis. High NET levels were present in LRT samples and persisted during the course of COVID-19, consistent with the detection of NETs in bronchi and alveolar spaces in lung tissue from fatal COVID-19 patients. Thus, NETs are produced and retained in the LRT of critical COVID-19 patients and could contribute to SARS-CoV-2-induced ARDS pathology.  

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