AI Article Synopsis
- Pulmonary fibrosis can develop after ARDS, and this study aims to identify biomarkers that predict the severity of ARDS and the risk of developing fibrosis.
- A longitudinal study measured various factors in COVID-related ARDS patients, revealing significant data patterns through statistical analysis, including a predictive model with a strong positive predictive value and a perfect negative predictive value.
- The research highlights that low levels of Angiotensin 1-7 and a specific composite index can predict ARDS progression to pulmonary fibrosis, potentially influencing treatment decisions for affected patients.
Article Abstract
Background: Pulmonary fibrosis can develop after acute respiratory distress syndrome (ARDS). The hypothesis is we are able to measure phenotypes that lie at the origin of ARDS severity and fibrosis development. The aim is an accuracy study of prognostic circulating biomarkers.
Methods: A longitudinal study followed COVID-related ARDS patients with medical imaging, pulmonary function tests and biomarker analysis, generating 444 laboratory data. Comparison to controls used non-parametrical statistics; p < 0·05 was considered significant. Cut-offs were obtained through receiver operating curve. Contingency tables revealed predictive values. Odds ratio was calculated through logistic regression.
Results: Angiotensin 1-7 beneath 138 pg/mL defined Angiotensin imbalance phenotype. Hyper-inflammatory phenotype showed a composite index test above 34, based on high Angiotensin 1-7, C-Reactive Protein, Ferritin and Transforming Growth Factor-β. Analytical study showed conformity to predefined goals. Clinical performance gave a positive predictive value of 95 % (95 % confidence interval, 82 %-99 %), and a negative predictive value of 100 % (95 % confidence interval, 65 %-100 %). Those severe ARDS phenotypes represented 34 (Odds 95 % confidence interval, 3-355) times higher risk for pulmonary fibrosis development (p < 0·001).
Conclusions: Angiotensin 1-7 composite index is an early and objective predictor of ARDS evolving to pulmonary fibrosis. It may guide therapeutic decisions in targeted phenotypes.
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| http://dx.doi.org/10.1016/j.cca.2024.119926 | DOI Listing |
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