Retrospective Study
Copyright ©The Author(s) 2023.
World J Crit Care Med. Sep 9, 2023; 12(4): 226-235
Published online Sep 9, 2023. doi: 10.5492/wjccm.v12.i4.226
Table 1 Patient characteristics
Baseline characteristics of the study cohort (n = 5)
Age (mean ± SD) yr48.2 (14.2)
Male: Female ratio4: 1
APACHE-II score at admission (median, IQR)19 (10-21)
Day of worsening from date of onset of symptoms (Median, IQR)32 (23-35)
Oxygenation parameters (median, IQR) PF ratio
Peak PF ratio prior to onset of DIPS326 (243-329)
PF ratio at onset of DIPS182 (156-190)
Peak PF ratio after immunomodulation353 (327-353)
Ventilation data (median, IQR) d
Duration of mechanical ventilationa prior to the onset of DIPS9 (2-16)
Duration of mechanical ventilation after the onset of DIPS 13 (10-23)
Inflammatory markers (median, IQR)
CRP (mg/L) at baseline142 (113-182)
CRP (mg/L) at onset of DIPS165.5 (157-212)
Ferritin (ng/mL) at baseline270.2 (191-349)
Ferritin (ng/mL) at onset of DIPS677.5 (382-1893)
IL-6 (pg/mL) at onset of DIPS (median, IQR)207.4 (163-311)
Table 2 Comparison of characteristics of coronavirus disease 2019 (COVID-19) associated acute respiratory distress syndrome, multisystem inflammatory syndrome Adults, multisystem inflammatory syndrome Children, post COVID-19 secondary organising pneumonia, post COVID-19 interstitial lung disease and Delayed Inflammatory Pulmonary Syndrome
SyndromeTime of onset (Median, IQR) dPrimary organ affectedOther organs affectedInflammatory markersTreatmentIntensive care required (%)Mortality, %
CARDS[11,12]8 (5-13) d from onset of infectionLungsGastro-intestinalElevated IL-2, IL7, TNF-αCorticosteroids, Baricitinib (JAK-2 inhibitor) and Tocilizumab (IL-6 inhibitor) in severe hypoxia and evidence of hyperinflammationYes (17)39
MIS-A[6]28 (20-36) d after SARS-CoV-2 infectionCardio-vascularGastro-intestinal, muco-cutaneous, haematologicalFibrinogen, D-dimer, CRP, ferritin, IL-6 elevated in > 90%IVIG (55%), corticosteroids (74%), IL-6 inhibitors (21%)Yes (57)7
MIS-C[2]Within 4 wk of SARS-CoV-2 infection (13)Gastro-intestinal tractMuco-cutaneousCRP, ferritin, procalcitonin, IL-6 elevatedIVIG (76.4%) and corticosteroids (52.3%), IL-1ra inhibitor (8.5%) and IL-6 inhibitors (6%)Yes (73.8)1.9
Secondary OP[7,8]Beyond 4 wk of SARS-CoV-2 infectionLungsNilCRP (mild elevation: 3.45 to 11.7 mg/dL)CorticosteroidsNoNil
Secondary ILD[9]6 wk after discharge from hospitalLungsUncommonCRP and ferritin significantly elevatedCorticosteroidsNoNil
DIPS (Current study)32 (23-35) d after symptom onsetLungsUncommonElevated CRP, ferritin, and IL-6Good response to IVIG/steroidsYes (100)20