Comparison of acute respiratory distress syndrome in patients with COVID-19 and influenza A (H7N9) virus infection. (September 2022)

• Record Type: Journal Article
• Authors: Ding, Ling; Chen, Yikun; Su, Nan; Xu, Xizhen; Yin, Jingping; Qiu, Jun; Wang, Jiajia; Zheng, Dong
• Is Part Of: International journal of infectious diseases. Volume 122(2022)
• Page Start: 593
• Page End: 598
• Publication Date: 2022-09
• Subjects: SARS-CoV-2 -- COVID-19 -- H7N9 -- Acute respiratory distress syndrome -- Disseminated intravascular coagulation; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2022.06.053
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Patients with H7N9- acute respiratory distress syndrome (ARDS) showed a more acute disease course and severity. Disseminated intravascular coagulation was more common in patients with COVID-19-ARDS. The main causes of death between H7N9-ARDS and COVID-19-ARDS were different. This is the first study to compare clinical features between the two diseases. Abstract: Objectives: We aimed to compared the clinical features of acute respiratory distress syndrome (ARDS) induced by COVID-19 and H7N9 virus infections. Methods: Clinical data of 100 patients with COVID-19 and 46 patients with H7N9 were retrospectively analyzed. Results: Elevated inflammatory indices and coagulation disorders were more common in COVID-19-ARDS group than in the H7N9-ARDS group. The median interval from illness onset to ARDS development was shorter in H7N9-ARDS. The PaO2 /FiO2 level was lower in H7N9-ARDS, whereas the Sepsis-related Organ Failure Assessment score was higher in COVID-19-ARDS. The proportion of patients with disseminated intravascular coagulation and liver injury in COVID-19-ARDS and H7N9-ARDS was 45.5% versus 3.1% and 28.8% versu s 50%, respectively ( P <0.05). The mean interval from illness onset to death was shorter in H7N9-ARDS. A total of 59.1% patients with H7N9-ARDS died of refractory hypoxemia compared with 28.9% with COVID-19-ARDS ( P = 0.014). Patients with COVID-19-ARDS were more likely to die of septic shock and multiple organ dysfunction compared with H7N9-ARDS (71.2% vs 36.4%, P = 0.005). Conclusion: Patients with H7N9 were more susceptible to develop severe ARDS and showed a more acute disease course. COVID-19-ARDS was associated with severe inflammatory response and coagulation dysfunction, whereas liver injury was more common in H7N9-ARDS. The main causes of death between patients with the two diseases were different.