Comparison of acute respiratory distress syndrome in patients with COVID-19 and influenza A (H7N9) virus infection

• DOI: 10.1016/j.ijid.2022.06.053
• Publication Date: 2022-07-03T13:45:24Z
• Authors: Ling Ding; Yikun Chen; Nan Su; Xizhen Xu; Jingping Yin; Jun Qiu; Jiajia Wang; Dong Zheng
• Keywords: 0301 basic medicine; Respiratory Distress Syndrome; Acute respiratory distress syndrome; SARS-CoV-2; COVID-19; Infectious and parasitic diseases; RC109-216; Disseminated intravascular coagulation; Influenza A Virus, H7N9 Subtype; Article; 3. Good health; H7N9; 03 medical and health sciences; Influenza, Human; Humans; Retrospective Studies

We aimed to compared the clinical features of acute respiratory distress syndrome (ARDS) induced by COVID-19 and H7N9 virus infections.Clinical data of 100 patients with COVID-19 and 46 patients with H7N9 were retrospectively analyzed.Elevated inflammatory indices and coagulation disorders were more common in COVID-19-ARDS group than in the H7N9-ARDS group. The median interval from illness onset to ARDS development was shorter in H7N9-ARDS. The PaO2/FiO2 level was lower in H7N9-ARDS, whereas the Sepsis-related Organ Failure Assessment score was higher in COVID-19-ARDS. The proportion of patients with disseminated intravascular coagulation and liver injury in COVID-19-ARDS and H7N9-ARDS was 45.5% versus 3.1% and 28.8% versus 50%, respectively (P <0.05). The mean interval from illness onset to death was shorter in H7N9-ARDS. A total of 59.1% patients with H7N9-ARDS died of refractory hypoxemia compared with 28.9% with COVID-19-ARDS (P = 0.014). Patients with COVID-19-ARDS were more likely to die of septic shock and multiple organ dysfunction compared with H7N9-ARDS (71.2% vs 36.4%, P = 0.005).Patients with H7N9 were more susceptible to develop severe ARDS and showed a more acute disease course. COVID-19-ARDS was associated with severe inflammatory response and coagulation dysfunction, whereas liver injury was more common in H7N9-ARDS. The main causes of death between patients with the two diseases were different.