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Review
. 2021 Oct;37(4):703-716.
doi: 10.1016/j.ccc.2021.05.001.

The Epidemiology of Acute Respiratory Distress Syndrome Before and After Coronavirus Disease 2019

Kathryn W Hendrickson  1 , Ithan D Peltan  2 , Samuel M Brown  3
Affiliations
Review

The Epidemiology of Acute Respiratory Distress Syndrome Before and After Coronavirus Disease 2019

Kathryn W Hendrickson et al. Crit Care Clin. 2021 Oct.

Abstract

Acute respiratory distress syndrome (ARDS) is a heterogeneous syndrome of high morbidity and mortality with global impact. Current epidemiologic estimates are imprecise given differences in patient populations, risk factors, resources, and practice styles around the world. Despite improvement in supportive care which has improved mortality, effective targeted therapies remain elusive. The Coronavirus Disease 2019 pandemic has resulted in a large number of ARDS cases that, despite less heterogeneity than multietiologic ARDS populations, still exhibit wide variation in physiology and outcomes. Intensive care unit rates of death have varied widely in studies to date because of a variety of patient and hospital-level factors. Despite some controversy, the best management of these patients is likely the same supportive measures shown to be effective in classical ARDS. Further epidemiologic studies are needed to help characterize the epidemiology of ARDS subphenotypes to facilitate identification of targeted therapies.

Keywords: ARDS; COVID-19; Epidemiology; Incidence; Mortality; Subtypes.

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Conflict of interest statement

Disclosure K.W. Hendrickson declares no disclosures. I.D. Peltan reports receiving research support from the National Institutes of Health, Centers for Disease Control, Janssen Pharmaceuticals, and Immunexpress, Inc. and support to institution from Regeneron and Asahi Kasei Pharma. S.M. Brown-please see pdf in Other Content tab.

Figures

Fig. 1
Fig. 1
Estimated overall hospital mortality rates for patients with ARDS of any severity. Hospital mortality reported in the main epidemiologic studies in all ARDS categories (mild, moderate, and severe). On the X-axis, the studies are chronologically ordered based on the study period.
Fig. 2
Fig. 2
Estimated mortality rates for patients with moderate-severe ARDS. Hospital mortality reported in the subgroups of moderate-severe ARDS. Moderate-severe ARDS hospital mortality in the study by Li and colleagues [2011] is reported in two different years of study, 2001 and 2008. On the X-axis, the studies are chronologically ordered based on the study period.
See this image and copyright information in PMC

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