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

1 SISTM - Statistics In System biology and Translational Medicine
2 BPH - Bordeaux population health

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.

Domaines: 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-04564226v1⟩