Comparison of Ventilator Mechanics and Mortality Between COVID-19 Versus Non-COVID-19 Acute Respiratory Distress Syndrome Patients: A Cross-Sectional Study.

Abstract

Background: We aim to assess the differences in ventilator mechanics and mortality of acute respiratory distress syndrome (ARDS) between patients with and without COVID-19. It might serve as a milestone in reshaping management protocols by providing very preliminary evidence in this direction.

Methods: It was a cross-sectional study that included adult patients aged 18 years or above admitted to the medical intensive care unit of our tertiary care hospital from January to December 2021 with the diagnosis of ARDS. Patients were divided into two groups. Group I were patients who had ARDS with COVID-19 infection while group II were those who had ARDS without COVID-19 infection. Both groups were compared in terms of clinical and respiratory mechanics of mechanical ventilators and mortality.

Results: The study included 135 patients, 68 of whom were in group I, and 67 were in group II. In the COVID-19 group, the median age was 60; while in the non-COVID-19 group, it was 64. There were 50% male patients in both groups. ARDS was more severe in COVID-19 (n = 44, 58%) than in the non-COVID group (n = 31, 41.3%, p-value = 0.030). The median PaO₂/FiO₂ ratio was 122.5 (interquartile range [IQR]: 93-160) in COVID-19 and was 180 (IQR: 127-248) in the non-COVID-19 group. Patient proning was higher (63% vs. 37%) in the COVID-19 group. In the COVID-19 group, 44 patients died compared to 32 in the non-COVID group (p-value = 0.060).

Conclusions: COVID-19 patients had severe ARDS compared with non-COVID patients. Despite this, ventilator mechanics and mortality were not significantly different between both groups. It appears that more proning strategies were observed in the COVID-19 group and may have some positive effects.