Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, USA.
Frank G Zarb School of Business at Hofstra University, Hempstead, USA.
BMC Pulm Med. 2022 Feb 4;22(1):51. doi: 10.1186/s12890-021-01732-y.
Understanding heterogeneity seen in patients with COVIDARDS and comparing to non-COVIDARDS may inform tailored treatments.
A multidisciplinary team of frontline clinicians and data scientists worked to create the Northwell COVIDARDS dataset (NorthCARDS) leveraging over 11,542 COVID-19 hospital admissions. The data was then summarized to examine descriptive differences based on clinically meaningful categories of lung compliance, and to examine trends in oxygenation.
Of the 1536 COVIDARDS patients in the NorthCARDS dataset, there were 531 (34.6%) who had very low lung compliance (< 20 ml/cmHO), 970 (63.2%) with low-normal compliance (20-50 ml/cmHO), and 35 (2.2%) with high lung compliance (> 50 ml/cmHO). The very low compliance group had double the median time to intubation compared to the low-normal group (107.3 h (IQR 25.8, 239.2) vs. 39.5 h (IQR 5.4, 91.6)). Overall, 68.8% (n = 1057) of the patients died during hospitalization. In comparison to non-COVIDARDS reports, there were less patients in the high compliance category (2.2% vs. 12%, compliance ≥ 50 mL/cmH20), and more patients with P/F ≤ 150 (59.8% vs. 45.6%). There is a statistically significant correlation between compliance and P/F ratio. The Oxygenation Index is the highest in the very low compliance group (12.51, SD(6.15)), and lowest in high compliance group (8.78, SD(4.93)).
The respiratory system compliance distribution of COVIDARDS is similar to non-COVIDARDS. In some patients, there may be a relation between time to intubation and duration of high levels of supplemental oxygen treatment on trajectory of lung compliance.
了解 COVIDARDS 患者的异质性，并将其与非 COVIDARDS 患者进行比较，可能有助于制定针对性的治疗方案。
一个由一线临床医生和数据科学家组成的多学科团队利用超过 11542 例 COVID-19 住院患者的数据创建了 Northwell COVIDARDS 数据集（NorthCARDS）。对数据进行了总结，以根据肺顺应性的临床有意义的类别检查描述性差异，并检查氧合趋势。
在 NorthCARDS 数据集中的 1536 名 COVIDARDS 患者中，有 531 名（34.6%）患者的肺顺应性非常低（<20 ml/cmHO），970 名（63.2%）患者的肺顺应性处于低正常值（20-50 ml/cmHO），35 名（2.2%）患者的肺顺应性较高（>50 ml/cmHO）。非常低的顺应性组与低正常组相比，插管中位时间翻了一番（107.3 小时（IQR 25.8，239.2）比 39.5 小时（IQR 5.4，91.6））。总体而言，68.8%（n=1057）的患者在住院期间死亡。与非 COVIDARDS 报告相比，顺应性较高的患者较少（2.2%比 12%，顺应性≥50 ml/cmH20），而 P/F≤150 的患者较多（59.8%比 45.6%）。顺应性和 P/F 比值之间存在显著的相关性。非常低的顺应性组的氧合指数最高（12.51，SD（6.15）），而顺应性较高的组最低（8.78，SD（4.93））。
COVIDARDS 的呼吸系统顺应性分布与非 COVIDARDS 相似。在某些患者中，插管时间和高水平补充氧气治疗的持续时间与肺顺应性的变化轨迹之间可能存在关系。
