Respiratory failure & ventilation
Pulmonary redox imbalance drives early fibroproliferative response in moderate/severe coronavirus disease-19 acute respiratory distress syndrome and impacts long-term lung abnormalities
Authors' conclusion
Pulmonary redox imbalance occurring early in COVID-19 ARDS patients drives fibroproliferative response and increases the risk of death. Long-term lung abnormalities post-COVID-19 are associated with early pulmonary fibroproliferation and redox imbalance.
Study context
- Population
- Mechanically ventilated patients with or without COVID-19 ARDS
- Participants
- 65 vs 63
- Exposure
- COVID-19 ARDS vs non-ARDS mechanically ventilated patients
- COVID-19 ARDSn = 65
- non-ARDSn = 63reference
- Outcome
- Chest CT fibrosis scores and BALF fibroproliferative and redox markers on admission
- Follow-up
- On admission
Methodological detailscomparative, follow-up at 3 months after discharge
- Comparative
- Follow-up at 3 months after discharge
Main finding
As reported in the abstract
- Higher chest CT fibrosis scores in COVID-19 ARDS vs non-ARDS
- p < 0.001
- Higher bronchoalveolar lavage fluid (BALF) NT-PCP-III, transforming growth factor (TGF)-β1, GSSG and malondialdehyde (MDA) in COVID-19 ARDS vs non-ARDS
- p < 0.001
- Lower BALF superoxide dismutase (SOD) and GSH in COVID-19 ARDS vs non-ARDS
- p < 0.001
- NT-PCP-III and TGF-β1 directly correlated with GSSG and MDA, inversely with SOD and GSH (COVID-19 ARDS)
- p < 0.001
Observational data: associations, not effects.
Further findings
Fibroproliferation and redox imbalance, non-survivors vs survivors (COVID-19 ARDS subgroup)
- Non-survivors (n = 28) showed significant pulmonary fibroproliferation vs survivors (n = 37)
- P < 0.001
- More severe redox imbalance in non-survivors
- P < 0.001
Residual pulmonary fibrosis and lung function impairment in survivors (n = 37) · 3 months after discharge
- Improved vs discharge
- P < 0.001
- Associated with early pulmonary fibroproliferation and redox imbalance
- P < 0.01
Original publication
Pulmonary redox imbalance drives early fibroproliferative response in moderate/severe coronavirus disease-19 acute respiratory distress syndrome and impacts long-term lung abnormalities. Ann Intensive Care. Published 12 May 2024. doi:10.
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