International Journal of General Medicine (Jul 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

  • Trebuian CI,
  • Popa D,
  • Buleu F,
  • Sutoi D,
  • Williams CG,
  • Crintea IN,
  • Chioibas RD,
  • Iancu A,
  • Ciolac L,
  • Mederle OA

Journal volume & issue
Vol. Volume 17
pp. 3337 – 3347

Abstract

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Cosmin Iosif Trebuian,1,2 Daian Popa,3,4 Florina Buleu,5,6 Dumitru Sutoi,1,5 Carmen Gabriela Williams,3 Iulia Najette Crintea,1,3 Raul Daniel Chioibas,1 Aida Iancu,7 Livia Ciolac,8 Ovidiu Alexandru Mederle1,3 1Department of Surgery I, “victor Babes” University of Medicine and Pharmacy, Timișoara, Romania; 2Emergency County Hospital, Reșita, Romania; 3Emergency Clinical Municipal Hospital, Timisoara, Romania; 4“victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 5Emergency County Hospital “pius Brinzeu”, Timișoara, Romania; 6Department of Cardiology “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 7Department of Radiology “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 8Clinic of Obstetrics and Gynecology, ”pius Brinzeu” County Clinical Emergency Hospital, Timisoara, RomaniaCorrespondence: Florina Buleu, Email [email protected] 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: pulmonary septic shock, severe ARDS, inflammatory biomarkers, COVID-19, outcomes

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