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== Classification == | == Classification == | ||
* COVID-19- | |||
Authors in a case report highlighted the nonuniformity of patients with [[COVID-19]]-associated ARDS and proposed the existence of two primary [[phenotypes]]: | |||
* Type L (low values of [[elastance]], pulmonary [[Ventilation/perfusion ratio|ventilation/ perfusion ratio]], lung weight, and recruitability). | |||
* Type H (high values of [[elastance]], right-to-left shunt, lung weight, and recruitability), more consistent with typical severe [[Acute respiratory distress syndrome|ARDS]].<ref name="FanBeitler2020">{{cite journal|last1=Fan|first1=Eddy|last2=Beitler|first2=Jeremy R|last3=Brochard|first3=Laurent|last4=Calfee|first4=Carolyn S|last5=Ferguson|first5=Niall D|last6=Slutsky|first6=Arthur S|last7=Brodie|first7=Daniel|title=COVID-19-associated acute respiratory distress syndrome: is a different approach to management warranted?|journal=The Lancet Respiratory Medicine|year=2020|issn=22132600|doi=10.1016/S2213-2600(20)30304-0}}</ref> | |||
ARDS is divided into three categories based on oxygenation index (PaO2/FiO2) on PEEP ≥ 5 cmH2O: | |||
* mild (200 mmHg ≤ PaO2/FiO2 < 300 mmHg), | |||
* mild-moderate (100 mmHg ≤ PaO2/FiO2 < 200 mmHg), and | |||
* moderate-severe (PaO2/FiO2 < 100 mmHg).<ref name="LiMa2020">{{cite journal|last1=Li|first1=Xu|last2=Ma|first2=Xiaochun|title=Acute respiratory failure in COVID-19: is it “typical” ARDS?|journal=Critical Care|volume=24|issue=1|year=2020|issn=1364-8535|doi=10.1186/s13054-020-02911-9}}</ref> | |||
<br /> | |||
== Pathophysiology == | |||
* | * | ||
Revision as of 13:45, 20 July 2020
Covid-19 Associated ARDS
Overview
Historical Perspective
- On 31 December 2019, the World Health Organization (WHO) was formally notified about a cluster of cases of pneumonia in Wuhan City.[1]
- Ten days later, WHO was aware of 282 confirmed cases, of which four were in Japan, South Korea and Thailand
- The virus responsible was isolated on 7 January and its genome shared on 12 January.The cause of the severe acute respiratory syndrome that became known as COVID‐19 was a novel coronavirus, SARS‐CoV‐2
- ARDS is one of the most important causes of hospital and ICU admission due to COVID.
- Many autopsies studies reported ARDS to be the cause of death in patients dying due to respiratory complications of COVID.
- As of July 19 2020 the number of total cases worldwide are 14,043,176 including 597,583 deaths, reported to WHO.
Classification
Authors in a case report highlighted the nonuniformity of patients with COVID-19-associated ARDS and proposed the existence of two primary phenotypes:
- Type L (low values of elastance, pulmonary ventilation/ perfusion ratio, lung weight, and recruitability).
- Type H (high values of elastance, right-to-left shunt, lung weight, and recruitability), more consistent with typical severe ARDS.[2]
ARDS is divided into three categories based on oxygenation index (PaO2/FiO2) on PEEP ≥ 5 cmH2O:
- mild (200 mmHg ≤ PaO2/FiO2 < 300 mmHg),
- mild-moderate (100 mmHg ≤ PaO2/FiO2 < 200 mmHg), and
- moderate-severe (PaO2/FiO2 < 100 mmHg).[3]
Pathophysiology
 |
![[1]](https://commons.wikimedia.org/w/index.php?search=covid&title=Special%3ASearch&go=Go&ns0=1&ns6=1&ns12=1&ns14=1&ns100=1&ns106=1#/media/File:Covid-19_San_Salvatore_02.jpg){kind=link}
| Criteria | Symptomatic WM | Asymptomatic WM | IgM-Related Disorders | MGUS |
|---|---|---|---|---|
| IgM monoclonal protein | + | + | + | + |
| Bone marrow infiltration | + | + | - | - |
| Symptoms attributable to IgM | + | - | + | - |
| Symptoms attributable to tumor infiltration | + | - | - | - |
|
Infra-Hisian Block Microchapters |
References
- ↑ 1.0 1.1 Chaplin, Steve (2020). "COVID
‐19: a brief history and treatments in development". Prescriber. 31 (5): 23–28. doi:10.1002/psb.1843. ISSN 0959-6682. line feed character in
|title=at position 6 (help) - ↑ Fan, Eddy; Beitler, Jeremy R; Brochard, Laurent; Calfee, Carolyn S; Ferguson, Niall D; Slutsky, Arthur S; Brodie, Daniel (2020). "COVID-19-associated acute respiratory distress syndrome: is a different approach to management warranted?". The Lancet Respiratory Medicine. doi:10.1016/S2213-2600(20)30304-0. ISSN 2213-2600.
- ↑ Li, Xu; Ma, Xiaochun (2020). "Acute respiratory failure in COVID-19: is it "typical" ARDS?". Critical Care. 24 (1). doi:10.1186/s13054-020-02911-9. ISSN 1364-8535.
- ↑ Kiran U, Aggarwal S, Choudhary A, Uma B, Kapoor PM (2017). "The blalock and taussig shunt revisited". Ann Card Anaesth. 20 (3): 323–330. doi:10.4103/aca.ACA_80_17. PMC 5535574. PMID 28701598.