Respiratory failure & ventilation
Novel subtypes of severe COVID-19 respiratory failure based on biological heterogeneity: a secondary analysis of a randomized controlled trial
Authors' conclusion
We discovered evidence of two novel biological subtypes of severe COVID-19 with significantly different clinical outcomes. These subtypes differed from previously established hyper- and hypo-inflammatory non-COVID subtypes of ARDS.
Study context
- Population
- Adults with severe COVID-19 hypoxemic respiratory failure requiring ≥ 6 L/min supplemental O2, enrolled September 2020 to October 2021
- Participants
- 400 adults
- Comparison
- Latent biological subtypes
Methodological detailslatent class analysis, multi-institutional platform trial
- Latent class analysis
- Multi-institutional platform trial
Primary result
As reported in the abstract
Latent subtypes and mortality
- Only one person classified as hyper-inflammatory by the validated non-COVID acute respiratory distress syndrome (ARDS) model
- 1
Further findings
Biomarkers associated with mortality · 28 and 60 days
- Inflammation (IL-6, IL-8, IL-10, sTNFR-1, TREM-1), epithelial injury (sRAGE) and endothelial injury (Ang-1, thrombomodulin) biomarkers associated with 28- and 60-day mortality
Overall 28-day mortality (all participants)
- 28-day mortality
- 25%
Original publication
Novel subtypes of severe COVID-19 respiratory failure based on biological heterogeneity: a secondary analysis of a randomized controlled trial. Crit Care. Published 21 February 2024. doi:10.
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