Clinical phenotypes of SARS-CoV-2

Patients with COVID-19 present a broad spectrum of clinical presentation. Whereas hypoxaemia is the marker of severity, different strategies of management should be customised to five specific individual phenotypes. Many intubated patients present with phenotype 4, characterised by pulmonary hypoxic...

Descripción completa

Detalles Bibliográficos
Autores: Rello, Jordi|||0000-0003-0676-6210, Storti, Enrico, Belliato, Mirko|||0000-0002-3411-6293, Serrano, R.
Tipo de recurso: artículo
Fecha de publicación:2020
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:225257
Acceso en línea:https://ddd.uab.cat/record/225257
https://dx.doi.org/urn:doi:10.1183/13993003.01028-2020
Access Level:acceso abierto
Palabra clave:ARDS
SARS-CoV-2
COVID-19
Acute Lung Injury
Betacoronavirus
Biomarkers
Biomedical Research
Coronavirus Infections
Disease Management
Female
Humans
Hypoxia
Lung Compliance
Male
Mechanical ventilation
Pandemics
Personalized medicine
Phenotype
Pneumonia, Viral
Procalcitonin
SARS Virus
Descripción
Sumario:Patients with COVID-19 present a broad spectrum of clinical presentation. Whereas hypoxaemia is the marker of severity, different strategies of management should be customised to five specific individual phenotypes. Many intubated patients present with phenotype 4, characterised by pulmonary hypoxic vasoconstriction, being associated with severe hypoxaemia with "normal" (>40 mL·cmH2O-1) lung compliance and likely representing pulmonary microvascular thrombosis. Phenotype 5 is often associated with high plasma procalcitonin and has low pulmonary compliance, Which is a result of co-infection or acute lung injury after noninvasive ventilation. Identifying these clinical phenotypes and applying a personalised approach would benefit the optimisation of therapies and improve outcomes.