CHEST Guidelines-Comparison-of-Hospitalized-Patients-With-ARDS-Caus (1)

Comparison-of-Hospitalized-Patients-With-ARDS-Caus (1)

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The study conducted by Xiao Tang, MD, Rong-Hui Du, MD, and others contrasts the clinical presentations and outcomes of Acute Respiratory Distress Syndrome (ARDS) caused by COVID-19 and H1N1 influenza. This retrospective case-control study involved analyzing 148 patients, 73 with COVID-19 and 75 with H1N1, aiming to distinguish differences in symptoms, treatments, and results.<br /><br />Key findings highlighted that COVID-19 patients were generally older and more often exhibited nonproductive coughs, fatigue, and gastrointestinal symptoms compared to H1N1 patients, who had higher Sequential Organ Failure Assessment (SOFA) scores and mortality rates. The COVID-19 cohort's PaO2/FIO2 was significantly better than H1N1, indicating less severe respiratory failure upon admission, though both had comparable in-hospital mortality rates: 28.8% for COVID-19 and 34.7% for H1N1, revealing higher severity after adjusting for SOFA scores in H1N1 cases.<br /><br />Imaging results showed ground-glass opacities were more common in COVID-19, with various antiviral therapies administered, illustrating the lack of a standardized treatment regime compared to H1N1, which was predominantly treated with Oseltamivir.<br /><br />The study calls attention to the difference in disease manifestations and suggests healthcare providers focus on distinct clinical presentations for effective differential diagnosis. It advocates for continued research, emphasizing the importance of prospective trials to further understand and effectively treat COVID-19, considering its distinct pathophysiology and clinical course compared to H1N1.<br /><br />Despite COVID-19’s generally less severe clinical presentation, standardizing treatments remains challenging due to its novel nature and evolving understanding, urging further exploration of therapeutic strategies, including respiratory supports like ECMO which might be critical given the pandemic conditions.

Keywords

ARDS

COVID-19

H1N1

clinical presentations

retrospective study

SOFA scores

mortality rates

ground-glass opacities

antiviral therapies

differential diagnosis