呼吸道病毒感染会导致严重的发病率和死亡率,从轻度无并发症的急性呼吸道疾病到严重的并发症,如急性呼吸窘迫综合征,多器官衰竭,以及流行病和大流行期间的死亡。我们提出了系统研究严重急性呼吸道感染(SARI)患者的方案,包括严重急性呼吸道综合征冠状病毒2,由于呼吸道病毒病原体,以评估自然史,预后生物标志物,和特点,包括医院的压力,与临床结果和严重程度相关。
方法:前瞻性队列研究。
方法:来自美国不同地理区域的至少15家医院的急性护理病房或ICU患者的多中心队列。
方法:由呼吸道病毒感染引起的SARI患者可引起暴发,流行病,和流行病。
方法:无。
结果:测量包括患者人口统计学,标志,症状,和药物;微生物学,成像,和相关测试;机械通气,医院程序,和其他干预措施;以及临床结果和医院压力,在入组后和出院时第0、3和7-14天收集的标本。主要结果指标是入院后的前30天内连续存活和无机械通气(VFD)的天数。重要的次要结果包括急性肾损伤前无器官衰竭天数,震惊,肝衰竭,弥散性血管内凝血,28天死亡率,适应性免疫,以及免疫学和微生物学结果。
结论:SARI准备是在重症监护医学发现协会合作下的多中心研究,弹性情报网,和国家新兴特殊病原体培训和教育中心,旨在提高对预后不良和资源利用率提高相关因素的理解。这可以导致干预以减轻与SARI相关的呼吸道病毒感染的临床影响。
Respiratory virus infections cause significant morbidity and mortality ranging from mild uncomplicated acute respiratory illness to severe complications, such as acute respiratory distress syndrome, multiple organ failure, and death during epidemics and pandemics. We present a protocol to systematically
study patients with severe acute respiratory infection (SARI), including severe acute respiratory syndrome coronavirus 2, due to respiratory viral pathogens to evaluate the natural history, prognostic biomarkers, and characteristics, including hospital stress, associated with clinical outcomes and severity.
METHODS: Prospective cohort
study.
METHODS: Multicenter cohort of patients admitted to an acute care ward or ICU from at least 15 hospitals representing diverse geographic regions across the United States.
METHODS: Patients with SARI caused by infection with respiratory viruses that can cause outbreaks, epidemics, and pandemics.
METHODS: None.
RESULTS: Measurements include patient demographics, signs, symptoms, and medications; microbiology, imaging, and associated tests; mechanical ventilation, hospital procedures, and other interventions; and clinical outcomes and hospital stress, with specimens collected on days 0, 3, and 7-14 after enrollment and at discharge. The primary outcome measure is the number of consecutive days alive and free of mechanical ventilation (VFD) in the first 30 days after hospital admission. Important secondary outcomes include organ failure-free days before acute kidney injury, shock, hepatic failure, disseminated intravascular coagulation, 28-day mortality, adaptive immunity, as well as immunologic and microbiologic outcomes.
CONCLUSIONS: SARI-Preparedness is a multicenter
study under the collaboration of the Society of Critical Care Medicine Discovery, Resilience Intelligence Network, and National Emerging Special Pathogen Training and Education Center, which seeks to improve understanding of prognostic factors associated with worse outcomes and increased resource utilization. This can lead to interventions to mitigate the clinical impact of respiratory virus infections associated with SARI.