An Analysis of Patients Followed Up in the Intensive Care Unit with the Diagnosis of Acute Respiratory Distress Syndrome

Global prevalence of COVID-19-induced acute respiratory distress syndrome: systematic review and meta-analysis

BACKGROUND

Acute respiratory distress syndrome (ARDS) is potentially a fatal form of respiratory failure among COVID-19 patients. Globally, there are inconsistent findings regarding ARDS among COVID-19 patients. Therefore, this study aimed to estimate the pooled prevalence of COVID-19-induced ARDS among COVID-19 patients worldwide.

METHODS

To retrieve relevant studies, the authors searched Embase, MEDLINE, PubMed, Web of Science, Cochrane Library, Google, and Google Scholar using a combination of search terms. The search was conducted for articles published from December 2019 to September 2022. Articles were searched and screened by title (ti), abstract (ab), and full-text (ft) by two reviewers independently. The quality of each included article was assessed using the Newcastle-Ottawa Assessment Scale. Data were entered into Microsoft Word and exported to Stata version 14 for analysis. Heterogeneity was detected using the Cochrane Q statistics and I-square (I2). Then the sources of variations were identified by subgroup and meta-regression analysis. A random effect meta-analysis model was used. The publication bias was detected using the graphic asymmetry test of the funnel plot and/or Egger's test (p value < 0.05). To treat the potential publication bias, trim and fill analysis were computed. The protocol has been registered in an international database, the Prospective Register of Systematic Reviews (PROSPERO) with reference number: CRD42023438277.

RESULTS

A total of 794 studies worldwide were screened for their eligibility. Of these 11 studies with 2845 participants were included in this systematic review and meta-analysis. The overall pooled prevalence of COVID-19-induced ARDS in the world was found to be 32.2% (95%CI = 27.70-41.73%), I2 = 97.3%, and p value < 0.001).

CONCLUSION

The pooled prevalence of COVID-19-induced ARDS was found to be high. The virus remains a global burden because its genetic causes are constantly changing or it mutated throughout the pandemic to emerge a new strain of infection. Therefore, interventions such as massive vaccination, early case detection, screening, isolation, and treatment of the cases need to be implemented to tackle its severity.

Correlation of microRNA-125a/b with acute respiratory distress syndrome risk and prognosis in sepsis patients

Objective

This study was conducted to explore the association of microRNA (miR)‐125a and miR‐125b with acute respiratory distress syndrome (ARDS) risk and to investigate their correlation with clinical characteristics and prognosis in sepsis patients.

Methods

Totally 150 sepsis patients admitted to our hospital were consecutively enrolled and another 150 healthy subjects were enrolled as healthy controls (HCs). Their blood samples were collected for miR‐125a and miR‐125b detection by real‐time quantitative polymerase chain reaction. Besides, ARDS occurrence and 28‐day mortality were documented in all sepsis patients.

Results

MiR‐125a and miR‐125b relative expressions were increased in ARDS‐sepsis patients/non‐ARDS‐sepsis patients compared with HCs, while only miR‐125b but not miR‐125a was elevated in ARDS‐sepsis patients compared with non‐ARDS‐sepsis patients. Receiver operating characteristic (ROC) curve presented that miR‐125a (AUC: 0.650, 95%CI: 0.549‐0.750) and miR‐125b (AUC: 0.739, 95%CI: 0.653‐0.823) could differentiate ARDS‐sepsis patients from non‐ARDS‐sepsis patients, and miR‐125b was of increased predictive value compared with miR‐125a numerically. In sepsis patients, miR‐125a relative expression was positively associated with serum creatinine (Scr), chronic health evaluation (APACHE) II score, sequential organ failure assessment (SOFA) score, and miR‐125b was positively associated with Scr, C‐reactive protein (CRP), APACHE II score, SOFA score, and chronic obstructive pulmonary disease. All sepsis patients were categorized into survivors and deaths according to 28‐day mortality, and miR‐125b but not miR‐125a was upregulated in deaths compared with survivors.

Conclusion

Both of miR‐125a and miR‐125b predict ARDS risk, while only miR‐125b is of value in prognosis prediction in sepsis patients.