ARDS Subphenotypes: Understanding a Heterogeneous Syndrome

Wilson, Jennifer G.; Calfee, Carolyn S.

doi:10.1186/s13054-020-2778-x

Cited by 149 publications

(105 citation statements)

References 52 publications

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“…This means that, while renal complications are more likely in patients with pre-existing chronic impairment of kidney function, moderate-to-severe AKI can also be found in patients with normal serum creatinine levels these may represent a higher-risk subset of patients with ARDS. Wilson et al [109] noted that similar observations have been reported for COVID-19-associated ARDS, which could develop into AKI on average 9 days after admission together with secondary infections and acute cardiac damage [26]. In ARDS, patients age, severity of illness and the presence of diabetes are all risk factors for acute kidney injury.…”

Section: Clinical Features In Patients With Acute Kidney Injury (Aki)mentioning

confidence: 62%

COVID-19 and the Kidney: From Epidemiology to Clinical Practice

Gagliardi

Patella

Michael

et al. 2020

JCM

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The new respiratory infectious disease coronavirus disease 2019 (COVID-19) that originated in Wuhan, China, in December 2019 and caused by a new strain of zoonotic coronavirus, named severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), to date has killed over 630,000 people and infected over 15,000,000 worldwide. Most of the deceased patients had pre-existing comorbidities; over 20% had chronic kidney disease (CKD). Furthermore, although SARS-CoV-2 infection is characterized mainly by diffuse alveolar damage and acute respiratory failure, acute kidney injury (AKI) has developed in a high percentage of cases. As AKI has been shown to be associated with worse prognosis, we believe that the impact of SARS-CoV-2 on the kidney should be investigated. This review sets out to describe the main renal aspects of SARS-CoV-2 infection and the role of the virus in the development and progression of kidney damage. In this article, attention is focused on the epidemiology, etiology and pathophysiological mechanisms of kidney damage, histopathology, clinical features in nephropathic patients (CKD, hemodialysis, peritoneal dialysis, AKI, transplantation) and prevention and containment strategies. Although there remains much more to be learned with regards to this disease, nonetheless it is our hope that this review will aid in the understanding and management of SARS-CoV-2 infection.

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Section: Clinical Features In Patients With Acute Kidney Injury (Aki)mentioning

confidence: 62%

COVID-19 and the Kidney: From Epidemiology to Clinical Practice

Gagliardi

Patella

Michael

et al. 2020

JCM

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“…AKI represents a life-threatening complication in critically ill patients, often leading to increased risk of death. As recently reported by Wilson et al, the onset of moderate-to-severe AKI described a higher-risk subset of ARDS patients, with a significant risk for mortality [4]. Considering the possible pathogenic mechanisms of AKI-associated ARDS, AKI may be ascribed to different causes such as impairment of gas exchange, hemodynamic alterations including right heart failure, fluid overload and systemic congestion, injurious mechanic ventilation strategies, and development of secondary infections/sepsis.…”

Section: Main Textmentioning

confidence: 87%

Acute kidney injury in SARS-CoV-2 infected patients

Fiorentino²,

et al. 2020

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“…Importantly, these studies have shown that ARDS is not a uniform disease, that it is heterogeneous and that this heterogeneity may be explored to enrich for specific outcomes [36] and help predict responses to different therapies.…”

Section: Ards Genomics and Transcriptomics Researchmentioning

confidence: 99%

Systems Biology ARDS Research with a Focus on Metabolomics

Metwaly

Winston

2020

Metabolites

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Acute respiratory distress syndrome (ARDS) is a clinical syndrome that inflicts a considerably heavy toll in terms of morbidity and mortality. While there are multitudes of conditions that can lead to ARDS, the vast majority of ARDS cases are caused by a relatively small number of diseases, especially sepsis and pneumonia. Currently, there is no clinically agreed upon reliable diagnostic test for ARDS, and the detection or diagnosis of ARDS is based on a constellation of laboratory and radiological tests in the absence of evidence of left ventricular dysfunction, as specified by the Berlin definition of ARDS. Virtually all the ARDS biomarkers to date have been proven to be of very limited clinical utility. Given the heterogeneity of ARDS due to the wide variation in etiology, clinical and molecular manifestations, there is a current scientific consensus agreement that ARDS is not just a single entity but rather a spectrum of conditions that need further study for proper classification, the identification of reliable biomarkers and the adequate institution of therapeutic targets. This scoping review aims to elucidate ARDS omics research, focusing on metabolomics and how metabolomics can boost the study of ARDS biomarkers and help to facilitate the identification of ARDS subpopulations.

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ARDS Subphenotypes: Understanding a Heterogeneous Syndrome

Cited by 149 publications

References 52 publications

COVID-19 and the Kidney: From Epidemiology to Clinical Practice

COVID-19 and the Kidney: From Epidemiology to Clinical Practice

Acute kidney injury in SARS-CoV-2 infected patients

Systems Biology ARDS Research with a Focus on Metabolomics

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