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Project description:Rationale COVID-19 can cause ARDS, a life-threatening condition that requires long-term ventilation. Neutrophil activation is a key mediator of lung injury in ARDS. However, the relationship between peripheral neutrophil RNA expression at the time of severe illness and 28-day ventilator weaning has not yet been clarified. Objectives To clarify the relationship with 28-day ventilator weaning and whole blood RNA sequencing analysis in COVID-19 patients. Moreover, single-cell RNA-seq was performed on neutrophils to analyze changes in gene expression levels for each fraction. Methods Bulk sequencing was performed using whole blood from 28 COVID-19 ARDS patients (9 in the non-ventilator weaning group and 19 in the ventilator weaning group) and 16 healthy controls. Next, single-cell RNA-seq was performed on neutrophils isolated from peripheral blood of 5 COVID-19 ARDS patients (3 in the non-ventilator weaning group and 2 in the ventilator weaning group) and 6 healthy individuals. Measurements and Main Results Although there was no clear difference between the non-ventilator weaning group and the ventilator weaning group in bulk RNA-seq using whole blood, the result of single-cell RNA-seq revealed clear differences between the non-ventilator weaning group, the ventilator weaning group, and healthy individuals. Conclusions Our study suggests that gene expression in neutrophils at the time of severe illness in COVID-19 ARDS patients may be associated with 28-day ventilator weaning.
2025-12-04 | GSE234903 | GEO
Project description:Rationale COVID-19 can cause ARDS, a life-threatening condition that requires long-term ventilation. Neutrophil activation is a key mediator of lung injury in ARDS. However, the relationship between peripheral neutrophil RNA expression at the time of severe illness and 28-day ventilator weaning has not yet been clarified. Objectives To clarify the relationship with 28-day ventilator weaning and whole blood RNA sequencing analysis in COVID-19 patients. Moreover, single-cell RNA-seq was performed on neutrophils to analyze changes in gene expression levels for each fraction. Methods Bulk sequencing was performed using whole blood from 28 COVID-19 ARDS patients (9 in the non-ventilator weaning group and 19 in the ventilator weaning group) and 16 healthy controls. Next, single-cell RNA-seq was performed on neutrophils isolated from peripheral blood of 5 COVID-19 ARDS patients (3 in the non-ventilator weaning group and 2 in the ventilator weaning group) and 6 healthy individuals. Measurements and Main Results Although there was no clear difference between the non-ventilator weaning group and the ventilator weaning group in bulk RNA-seq using whole blood, the result of single-cell RNA-seq revealed clear differences between the non-ventilator weaning group, the ventilator weaning group, and healthy individuals. Conclusions Our study suggests that gene expression in neutrophils at the time of severe illness in COVID-19 ARDS patients may be associated with 28-day ventilator weaning.
2025-12-04 | GSE234902 | GEO
Project description:Association of Neutrophil Gene Expression with 28-Day Ventilator Weaning in COVID-19 ARDS Patients
| PRJNA983713 | ENA
Project description:Association of Neutrophil Gene Expression with 28-Day Ventilator Weaning in COVID-19 ARDS Patients (part 1)
| PRJNA983711 | ENA
Project description:Association of Neutrophil Gene Expression with 28-Day Ventilator Weaning in COVID-19 ARDS Patients (part 2)
| PRJNA983718 | ENA
Project description:ObjectiveThis study was performed to explore the association of the high-resolution computed tomography (HRCT) score with ventilator weaning and 28-day mortality of patients with acute respiratory distress syndrome (ARDS).MethodIn total, 197 patients treated for ARDS from October 2004 to December 2015 were retrospectively analyzed. Univariate analysis and multifactor regression analysis were used to determine the relationship of the HRCT score with ventilator weaning and 28-day mortality. Curve-fitting analysis and threshold analysis were further used to explore the association of the HRCT score with ventilator weaning and 28-day mortality.ResultsThe multifactor regression analysis showed that the HRCT score was significantly associated with a lower rate of ventilator weaning and a higher risk of 28-day mortality in patients with ARDS. HRCT scores of 257.0 and 243.2 were the thresholds for ventilator weaning and 28-day mortality, respectively. When the HRCT score was below the threshold, every 1-point increase in the HRCT score was associated with a 4.6% decrease in the ventilator weaning rate and a 4.6% increase in the 28-day mortality rate.ConclusionThe HRCT score was associated with ventilator weaning and 28-day mortality with a threshold of 257.0 and 243.2 points, respectively.
| S-EPMC7288822 | biostudies-literature
Project description:BackgroundEstimates for dead space ventilation have been shown to be independently associated with an increased risk of mortality in the acute respiratory distress syndrome and small case series of COVID-19-related ARDS.MethodsSecondary analysis from the PRoVENT-COVID study. The PRoVENT-COVID is a national, multicenter, retrospective observational study done at 22 intensive care units in the Netherlands. Consecutive patients aged at least 18 years were eligible for participation if they had received invasive ventilation for COVID-19 at a participating ICU during the first month of the national outbreak in the Netherlands. The aim was to quantify the dynamics and determine the prognostic value of surrogate markers of wasted ventilation in patients with COVID-19-related ARDS.ResultsA total of 927 consecutive patients admitted with COVID-19-related ARDS were included in this study. Estimations of wasted ventilation such as the estimated dead space fraction (by Harris-Benedict and direct method) and ventilatory ratio were significantly higher in non-survivors than survivors at baseline and during the following days of mechanical ventilation (p < 0.001). The end-tidal-to-arterial PCO2 ratio was lower in non-survivors than in survivors (p < 0.001). As ARDS severity increased, mortality increased with successive tertiles of dead space fraction by Harris-Benedict and by direct estimation, and with an increase in the VR. The same trend was observed with decreased levels in the tertiles for the end-tidal-to-arterial PCO2 ratio. After adjustment for a base risk model that included chronic comorbidities and ventilation- and oxygenation-parameters, none of the dead space estimates measured at the start of ventilation or the following days were significantly associated with 28-day mortality.ConclusionsThere is significant impairment of ventilation in the early course of COVID-19-related ARDS but quantification of this impairment does not add prognostic information when added to a baseline risk model.Trial registrationISRCTN04346342. Registered 15 April 2020. Retrospectively registered.
| S-EPMC8127435 | biostudies-literature
Project description:This study aimed to evaluate the effect of two restrictive cumulative fluid balance (CFB) trends on survival and on major clinical outcomes in invasively ventilated patients with moderate to severe respiratory distress syndrome (ARDS) due to SARS-CoV-2. Prospective data collection was conducted on patients in the intensive care unit (ICU) originating from a tertiary university hospital. The primary outcomes were the risk association between the CFB trend during D0 to D7 and 28-day survival. The secondary outcomes were ICU mortality, in-hospital mortality, the need for invasive ventilation at D28, administration of vasoactive drugs at D7, time on invasive ventilation after D7, and length of ICU and hospital stay. 171 patients were enrolled in the study and divided according to their CFB trends during seven days of follow-up using model-based clustering [median CFB negative trend (n = 89) - 279 ml (- 664 to 203) and (n = 82) median CFB positive trend 1362 ml (619-2026)]. The group with CFB negative trend showed a higher chance of surviving 28-day in the ICU (HR: 0.62, 95% CI 0.41-0.94, p = 0.038). Moreover, this group had a reduced length of stay in the ICU, 11 (8-19) days versus 16.5 (9-29) days p = 0.004 and presented lower rates (OR = 0.22; 95% CI 0.09-0.52) of invasive ventilation after 28-days in the ICU. In patients invasively ventilated with moderate to severe ARDS due to COVID-19, the collective who showed a negative trend in the CFB after seven days of invasive ventilation had a higher chance of surviving 28 days in the ICU and lower length of stay in the ICU.
| S-EPMC10613222 | biostudies-literature
Project description:RationaleEarly corticosteroid treatment is used to treat COVID-19-related acute respiratory distress syndrome (ARDS). Infection is a well-documented adverse effect of corticosteroid therapy.ObjectivesTo determine whether early corticosteroid therapy to treat COVID-19 ARDS was associated with ventilator-associated pneumonia (VAP).MethodsWe retrospectively included adults with COVID-19-ARDS requiring invasive mechanical ventilation (MV) for ≥ 48 h at any of 15 intensive care units in 2020. We divided the patients into two groups based on whether they did or did not receive corticosteroids within 24 h. The primary outcome was VAP incidence, with death and extubation as competing events. Secondary outcomes were day 90-mortality, MV duration, other organ dysfunctions, and VAP characteristics.Measurements and main resultsOf 670 patients (mean age, 65 years), 369 did and 301 did not receive early corticosteroids. The cumulative VAP incidence was higher with early corticosteroids (adjusted hazard ratio [aHR] 1.29; 95% confidence interval [95% CI] 1.05-1.58; P = 0.016). Antibiotic resistance of VAP bacteria was not different between the two groups (odds ratio 0.94, 95% CI 0.58-1.53; P = 0.81). 90-day mortality was 30.9% with and 24.3% without early corticosteroids, a nonsignificant difference after adjustment on age, SOFA score, and VAP occurrence (aHR 1.15; 95% CI 0.83-1.60; P = 0.411). VAP was associated with higher 90-day mortality (aHR 1.86; 95% CI 1.33-2.61; P = 0.0003).ConclusionsEarly corticosteroid treatment was associated with VAP in patients with COVID-19-ARDS. Although VAP was associated with higher 90-day mortality, early corticosteroid treatment was not. Longitudinal randomized controlled trials of early corticosteroids in COVID-19-ARDS requiring MV are warranted.
| S-EPMC9344449 | biostudies-literature
Project description:ObjectiveTo assess the association between neutrophil percentage-to-albumin ratio (NPAR) and 28-day mortality in severely ill Chinese patients with sepsis.MethodsIn this retrospective, single-centre study, sepsis patients admitted to the ICU of the Affiliated Hospital of Jining Medical University between May 2015 and December 2021 were retrospectively analysed. The relationship between NPAR and 28-day mortality was examined using Cox proportional-hazards model.ResultsIn total, 741 patients with sepsis were included. Multivariate analysis, adjusted for age, sex, body mass index (BMI), smoking and alcohol drinking history, showed an association between elevated NPAR and a high risk of 28-day mortality. After removal of additional confounders, moderate and high NPAR values remained significantly associated with 28-day mortality in comparison with low NPAR values (tertile 2 vs 1: HR, 95% CI: 1.42, 1.06-1.90; tertile 3 vs 1: HR, 95% CI: 1.35, 1.00-1.82). Survival curves stratified by NPAR groups showed that high NPAR levels had lower survival probabilities than lower NPAR levels. Subgroup analysis did not show any significant interactions between NPAR and 28-day mortality.ConclusionsElevated NPAR values were linked to increased 28-day mortality in severely ill Chinese patients with sepsis. The findings require verification by large, prospective, multi-centre studies.
| S-EPMC10291015 | biostudies-literature