PLoS ONE (Jan 2023)

Acute respiratory distress syndrome after SARS-CoV-2 infection on young adult population: International observational federated study based on electronic health records through the 4CE consortium.

  • Bertrand Moal,
  • Arthur Orieux,
  • Thomas Ferté,
  • Antoine Neuraz,
  • Gabriel A Brat,
  • Paul Avillach,
  • Clara-Lea Bonzel,
  • Tianxi Cai,
  • Kelly Cho,
  • Sébastien Cossin,
  • Romain Griffier,
  • David A Hanauer,
  • Christian Haverkamp,
  • Yuk-Lam Ho,
  • Chuan Hong,
  • Meghan R Hutch,
  • Jeffrey G Klann,
  • Trang T Le,
  • Ne Hooi Will Loh,
  • Yuan Luo,
  • Adeline Makoudjou,
  • Michele Morris,
  • Danielle L Mowery,
  • Karen L Olson,
  • Lav P Patel,
  • Malarkodi J Samayamuthu,
  • Fernando J Sanz Vidorreta,
  • Emily R Schriver,
  • Petra Schubert,
  • Guillaume Verdy,
  • Shyam Visweswaran,
  • Xuan Wang,
  • Griffin M Weber,
  • Zongqi Xia,
  • William Yuan,
  • Harrison G Zhang,
  • Daniela Zöller,
  • Isaac S Kohane,
  • Consortium for Clinical Characterization of COVID-19 by EHR (4CE),
  • Alexandre Boyer,
  • Vianney Jouhet

DOI
https://doi.org/10.1371/journal.pone.0266985
Journal volume & issue
Vol. 18, no. 1
p. e0266985

Abstract

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PurposeIn young adults (18 to 49 years old), investigation of the acute respiratory distress syndrome (ARDS) after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been limited. We evaluated the risk factors and outcomes of ARDS following infection with SARS-CoV-2 in a young adult population.MethodsA retrospective cohort study was conducted between January 1st, 2020 and February 28th, 2021 using patient-level electronic health records (EHR), across 241 United States hospitals and 43 European hospitals participating in the Consortium for Clinical Characterization of COVID-19 by EHR (4CE). To identify the risk factors associated with ARDS, we compared young patients with and without ARDS through a federated analysis. We further compared the outcomes between young and old patients with ARDS.ResultsAmong the 75,377 hospitalized patients with positive SARS-CoV-2 PCR, 1001 young adults presented with ARDS (7.8% of young hospitalized adults). Their mortality rate at 90 days was 16.2% and they presented with a similar complication rate for infection than older adults with ARDS. Peptic ulcer disease, paralysis, obesity, congestive heart failure, valvular disease, diabetes, chronic pulmonary disease and liver disease were associated with a higher risk of ARDS. We described a high prevalence of obesity (53%), hypertension (38%- although not significantly associated with ARDS), and diabetes (32%).ConclusionTrough an innovative method, a large international cohort study of young adults developing ARDS after SARS-CoV-2 infection has been gather. It demonstrated the poor outcomes of this population and associated risk factor.