Published online Jan 16, 2021. doi: 10.12998/wjcc.v9.i2.344
Peer-review started: October 16, 2020
First decision: October 27, 2020
Revised: October 30, 2020
Accepted: November 12, 2020
Article in press: November 12, 2020
Published online: January 16, 2021
Processing time: 83 Days and 16.3 Hours
There were few reports on the risk factors of acute respiratory distress syndrome (ARDS) in coronavirus disease 2019 (COVID-19), and the differences in ADRS incidence between Wuhan and outside Wuhan in China.
To identify the risk factors of ARDS in COVID-19, and determine whether the incidence of ADRS in Wuhan was overestimated compared to real world research.
The first objective of this study was to identify the risk factors for ARDS in COVID-19 patients, and the second objective was to compare the different characteristics of ARDS between Wuhan and non-Wuhan studies in China.
We retrospectively collected the patients’ clinical data, and the factors associated with ARDS were compared using the χ² test, Fisher’s exact test, Mann-Whitney U test. Univariate and multivariate logistic regression was used to compute and adjust odds ratio value. The ARDS incidence, mortality rate, and biomarkers of COVID-19 severity were collected and compared between studies in and outside Wuhan after literature review.
Older age, coexisting diseases, lower lymphocytes/albumin, higher D-dimer and C-reactive protein levels all affected the incidence of ADRS, and dyspnea, dry/moist rales and higher lactate dehydrogenase level were three independent risk factors. The ARDS incidence, mortality rate, and biomarkers of COVID-19 severity were higher in Wuhan than outside Wuhan in China.
There were some risk factors associated with ARDS in COVID-19. The higher ARDS rate in Wuhan may result from the shortage of medical resources in the early stage of the epidemic. These findings may provide references for the researchers and policy makers of COVID-19.
Biomarkers of disease severity are important risk factors for ARDS in COVID-19. The incidence of the disease should be assessed comprehensively. Accurate estimation of the incidence of ARDS will be helpful to both health workers and policy makers to develop appropriate strategies for COVID-19.