Acute respiratory distress syndrome after SARS-CoV-2 infection on young adult population: International observational federated study based on electronic health records through the 4CE consortium

Bertrand Moal (1) , Arthur Orieux (1) , Thomas Ferte (2, 3) , Antoine Neuraz (4) , Gabriel A Brat (5) , Paul Avillach (5) , Clara-Lea Bonzel (5) , Tianxi Cai (5) , Kelly Cho (6) , Sebastien Cossin (3) , Romain Griffier (7) , David A Hanauer (3) , Christian Haverkamp (8) , Yuk-Lam Ho (7) , Chuan Hong (5) , Meghan R Hutch (6) , Jeffrey G Klann (9) , Trang T Le (5) , Ne Hooi Will Loh (10) , Yuan Luo (7) , Adeline Makoudjou (11) , Michele Morris (5) , Danielle L Mowery (5) , Karen L Olson (12) , Lav P Patel (7) , Malarkodi J Samayamuthu (5) , Fernando J Sanz Vidorreta (13) , Emily R Schriver (14) , Petra Schubert (15) , Guillaume Verdy (1) , Shyam Visweswaran (5) , Xuan Wang (5) , Griffin M Weber (5) , Zongqi Xia (11) , William Yuan (5) , Harrison G Zhang (5) , Daniela Zoller (16) , Isaac S Kohane (5) , Alexandre Boyer (1) , Vianney Jouhet (3)

1 CHU Bordeaux
2 SISTM - Statistics In System biology and Translational Medicine
3 BPH - Bordeaux population health
4 Hôpital Necker - Enfants Malades [AP-HP]
5 HMS - Harvard Medical School [Boston]
6 VA Boston Healthcare System
7 University of Freiburg [Freiburg]
8 University of Michigan [Ann Arbor]
9 Northwestern University [Chicago, Ill. USA]
10 Massachusetts General Hospital [Boston]
11 University of Pennsylvania
12 NUHS - National University Health System [Singapore]
13 Boston Children's Hospital
14 University of Kansas Medical Center [Kansas City, KS, USA]
15 David Geffen School of Medicine [Los Angeles]
16 PITT - University of Pittsburgh

PURPOSE: In young adults (18 to 49 years old), investigation of the acute respiratory distress syndrome (ARDS) after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been limited. We evaluated the risk factors and outcomes of ARDS following infection with SARS-CoV-2 in a young adult population. METHODS: A retrospective cohort study was conducted between January 1st, 2020 and February 28th, 2021 using patient-level electronic health records (EHR), across 241 United States hospitals and 43 European hospitals participating in the Consortium for Clinical Characterization of COVID-19 by EHR (4CE). To identify the risk factors associated with ARDS, we compared young patients with and without ARDS through a federated analysis. We further compared the outcomes between young and old patients with ARDS. RESULTS: Among the 75,377 hospitalized patients with positive SARS-CoV-2 PCR, 1001 young adults presented with ARDS (7.8% of young hospitalized adults). Their mortality rate at 90 days was 16.2% and they presented with a similar complication rate for infection than older adults with ARDS. Peptic ulcer disease, paralysis, obesity, congestive heart failure, valvular disease, diabetes, chronic pulmonary disease and liver disease were associated with a higher risk of ARDS. We described a high prevalence of obesity (53%), hypertension (38%- although not significantly associated with ARDS), and diabetes (32%). CONCLUSION: Trough an innovative method, a large international cohort study of young adults developing ARDS after SARS-CoV-2 infection has been gather. It demonstrated the poor outcomes of this population and associated risk factor.

Domains: Santé publique et épidémiologie

Bertrand Moal, Arthur Orieux, Thomas Ferte, Antoine Neuraz, Gabriel A Brat, et al.. Acute respiratory distress syndrome after SARS-CoV-2 infection on young adult population: International observational federated study based on electronic health records through the 4CE consortium. PLoS ONE, 2023, 18 (1), pp.e0266985. ⟨10.1371/journal.pone.0266985⟩. ⟨hal-04564226v2⟩