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What is acute respiratory distress syndrome, ARDS?
Acute respiratory distress syndrome, also known as ARDS, is a common killer among critically ill patients hospitalized with COVID-19.
But even if they survive, it’s a long way to recovery.
Patients develop ARDS in the later stages of infection the virus has caused significant damage to the lungs. In the process of fighting the virus, the body sends immune cells to the lungs, causing an inflammatory reaction.
The reaction can leak small blood vessels into the lungs and fill the alveoli, which are tiny air sacs in the lungs that process oxygen, according to the American Lung Association. This makes it difficult for oxygen to enter the bloodstream and reach the organs of the body.
At this point, critical patients are put on a ventilator to facilitate the flow of oxygen, but in some cases it is not enough for the body to function and the patient dies.
In other cases, even if patients are removed from the ventilator, there is still a 30% chance of dying in 30 days, according to an extensive ARDS study called Lung study.
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Dr. Nuala Meyer, Associate Professor at the University of Pennsylvania’s Perelman School of Medicine, says preliminary reports from China and South Korea indicate that COVID-19 patients who develop ARDS are removed from the ventilator after 10 to 14 days.
She added that patients who survive ARDS face a long process to recover from physical and cognitive impairments.
Patients tend to lose peripheral muscle mass and muscle function, she said. Five years after discharge from the hospital, ARDS survivors are significantly below their ability to walk and how far away from their peers.
They also have difficulty swallowing and speaking due to trauma caused by the breathing tube that enters the vocal cords.
A 2016 study published inIntensive care medicine found that patients suffered from cognitive impairment up to five years after leaving the hospital. Survivors’ cognitive impairment ranged from 70% to 100% after discharge from the hospital, 80% one year later and up to 20% five years later.
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In addition to cognitive impairment, the study also found that patients and their caregivers were more likely to suffer from psychiatric conditions such as depression, anxiety and post-traumatic stress disorder.
Depression takes a very physical form, explained Meyer. Be sad to lose what you have been able to do.
Although many aspects of the body appear to take longer to recover, studies show that the lungs are almost normal five years after discharge from the hospital.
Experts say that many patients hospitalized for severe and critical COVID-19 develop ARDS. In one A JAMA study published last week, 84 out of 201 patients developed ARDS and of these 84 patients, 44 died.
The study researchers concluded that older age was associated with an increased risk of developing ARDS and dying. They also found that ARDS patients were able to recover when they had a higher fever, a sign that the body was fighting the infection.
Critically ill patients can develop ARDS faster than you might think. According to a study published in January in peer-reviewed journals, ARDS developed in 17 to 29% of COVID-19 hospital patients and the median time between onset of symptoms and ARDS was eight days.
However, Dr. Abhijit Duggal, an intensive care specialist at the Cleveland Clinic, says that the preliminary trends that experts observe with COVID-19 are very similar to other pandemics of the past.
“If you look at the H1N1 pandemic, we have seen very similar figures where people who have developed a serious serious illness, requiring mechanical ventilation, have developed ARDS,” he said. “Like any other viral disease.”
He also says that about 80% of COVID-19 patients recover without complications.
Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.
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