Identifying Clinical Phenotypes in Moderate to Severe Acute Respiratory Distress Syndrome Related to COVID-19: The COVADIS Study - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Frontiers in Medicine Année : 2021

Identifying Clinical Phenotypes in Moderate to Severe Acute Respiratory Distress Syndrome Related to COVID-19: The COVADIS Study

Andre Ly
  • Fonction : Auteur
Francois Lejeune
  • Fonction : Auteur
Julien Textoris
David Grimaldi
  • Fonction : Auteur
  • PersonId : 1131003

Résumé

Objectives: Different phenotypes have been identified in acute respiratory distress syndrome (ARDS). Existence of several phenotypes in coronavirus disease (COVID-19) related acute respiratory distress syndrome is unknown. We sought to identify different phenotypes of patients with moderate to severe ARDS related to COVID-19. Methods: We conducted an observational study of 416 COVID-19 patients with moderate to severe ARDS at 21 intensive care units in Belgium and France. The primary outcome was day-28 ventilatory free days. Secondary outcomes were mortality on day 28, acute kidney injury, acute cardiac injury, pulmonary embolism, and deep venous thrombosis. Multiple factor analysis and hierarchical classification on principal components were performed to distinguish different clinical phenotypes. Results: We identified three different phenotypes in 150, 176, and 90 patients, respectively. Phenotype 3 was characterized by short evolution, severe hypoxemia, and old comorbid patients. Phenotype 1 was mainly characterized by the absence of comorbidities, relatively high compliance, and long duration of symptoms, whereas phenotype 2 was characterized female sex, and the presence of mild comorbidities such as uncomplicated diabetes or chronic hypertension. The compliance in phenotype 2 was lower than that in phenotype 1, with higher plateau and driving pressure. Phenotype 3 was associated with higher mortality compared to phenotypes 1 and 2. Conclusions: In COVID-19 patients with moderate to severe ARDS, we identified three clinical phenotypes. One of these included older people with comorbidities who had a fulminant course of disease with poor prognosis. Requirement of different treatments and ventilatory strategies for each phenotype needs further investigation.
Fichier principal
Vignette du fichier
fmed-08-632933.pdf (748.91 Ko) Télécharger le fichier
Origine : Fichiers éditeurs autorisés sur une archive ouverte

Dates et versions

hal-03620022 , version 1 (25-03-2022)

Identifiants

Citer

Jean-Baptiste Lascarrou, Aurelie Gaultier, Thibaud Soumagne, Nicolas Serck, Bertrand Sauneuf, et al.. Identifying Clinical Phenotypes in Moderate to Severe Acute Respiratory Distress Syndrome Related to COVID-19: The COVADIS Study. Frontiers in Medicine, 2021, 8, pp.632933. ⟨10.3389/fmed.2021.632933⟩. ⟨hal-03620022⟩
100 Consultations
24 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More