Clinical phenotypes of SARS-CoV-2: implications for clinicians and researchers.

Authors :: Rello J
Storti E
Belliato M
Serrano R
Source :: The European respiratory journal [Eur Respir J] 2020 May 21; Vol. 55 (5). Date of Electronic Publication: 2020 May 21 (Print Publication: 2020).
Publication Year :: 2020
Abstract: Patients with COVID-19 present a broad spectrum of clinical presentation. Whereas hypoxaemia is the marker of severity, different strategies of management should be customised to five specific individual phenotypes. Many intubated patients present with phenotype 4, characterised by pulmonary hypoxic vasoconstriction, being associated with severe hypoxaemia with "normal" (>40 mL·cmH <subscript>2</subscript> O <superscript>-1</superscript> ) lung compliance and likely representing pulmonary microvascular thrombosis. Phenotype 5 is often associated with high plasma procalcitonin and has low pulmonary compliance, Which is a result of co-infection or acute lung injury after noninvasive ventilation. Identifying these clinical phenotypes and applying a personalised approach would benefit the optimisation of therapies and improve outcomes.<br />Competing Interests: Conflict of interest: J. Rello has nothing to disclose. Conflict of interest: E. Storti has nothing to disclose. Conflict of interest: M. Belliato reports personal fees for lectures from Hamilton Medical, Swiss and Bonaduz, outside the submitted work. Conflict of interest: R. Serrano has nothing to disclose.<br /> (Copyright ©ERS 2020.)