Observational studyThe Lancet. Respiratory medicine2020
Prevalence of phenotypes of acute respiratory distress syndrome in critically ill patients with COVID-19: a prospective observational study.
Observational study in The Lancet. Respiratory medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05108896 (Aspiration in Acute Respiratory Failure Survivors), which is not on this map. Cited by 155 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Aspiration in Acute Respiratory Failure Survivors
Who cites it
155 citing papers in PubMed, 5 syntheses or guidelines pooled it, 263 citations in OpenAlex.
- Association Between the Level of Vitamin D and COVID-19 Infection in Children and Adolescents: A Systematic Review.The American journal of tropical medicine and hygiene · 2024Pooled it
- Pooled it
- Identification of Parameters Representative of Immune Dysfunction in Patients with Severe and Fatal COVID-19 Infection: a Systematic Review and Meta-analysis.Clinical reviews in allergy & immunology · 2023Pooled it
- Hemoperfusion and blood purification strategies in patients with COVID-19: A systematic review.Artificial organs · 2021Pooled it
- Cytokine elevation in severe and critical COVID-19: a rapid systematic review, meta-analysis, and comparison with other inflammatory syndromes.The Lancet. Respiratory medicine · 2020Pooled it
- Longitudinal multiomic signatures of ARDS and sepsis inflammatory phenotypes identify pathways associated with mortality.The Journal of clinical investigation · 2026Trial
- Safety and efficacy of inhaled PEG-ADM in ARDS patients: a randomised controlled trial.Critical care (London, England) · 2025Trial
- Biologic Mechanisms Underlying the Heterogeneous Response to Tight Glycemic Control among Differentially Inflamed Patients in the HALF-PINT Trial.American journal of respiratory and critical care medicine · 2025Trial
- Novel subtypes of severe COVID-19 respiratory failure based on biological heterogeneity: a secondary analysis of a randomized controlled trial.Critical care (London, England) · 2024Trial
- A Randomized Trial of Mesenchymal Stromal Cells for Moderate to Severe Acute Respiratory Distress Syndrome from COVID-19.American journal of respiratory and critical care medicine · 2023Trial
- Atorvastatin versus placebo in patients with covid-19 in intensive care: randomized controlled trial.BMJ (Clinical research ed.) · 2022Trial
- An investigation into the beneficial effects of high-dose interferon beta 1-a, compared to low-dose interferon beta 1-a in severe COVID-19: The COVIFERON II randomized controlled trial.International immunopharmacology · 2021Trial
- Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19.The New England journal of medicine · 2021Trial
- Longitudinal assessment of IFN-I activity and immune profile in critically ill COVID-19 patients with acute respiratory distress syndrome.Critical care (London, England) · 2021Trial
- Subphenotype-specific serum proteomic signatures in patients with ARDS.Journal of intensive care · 2026Article
- Protein Quantification Platforms For Use In Critical Care Precision Medicine Trials: A Scoping Review.Critical care explorations · 2026Article
- The molecular ICU: a primer on omics, informatics and the future of precision critical care.Critical care (London, England) · 2026Review
- Cytokine-based strategies to improve prognostic enrichment of pediatric ARDS.Critical care (London, England) · 2026Observational
- A Clinical Predictor of Lung Molecular Endotype Identifies Heterogeneity in Corticosteroid Response in Severe COVID-19: an Emulated Target Trial.medRxiv : the preprint server for health sciences · 2026Article
- Cytokine storm in acute respiratory distress syndrome.Journal of intensive medicine · 2026Review
95 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
18 authors at 9 institutions in 3 countries.
Funding
Abstract
backgroundIn acute respiratory distress syndrome (ARDS) unrelated to COVID-19, two phenotypes, based on the severity of systemic inflammation (hyperinflammatory and hypoinflammatory), have been described. The hyperinflammatory phenotype is known to be associated with increased multiorgan failure and mortality. In this study, we aimed to identify these phenotypes in COVID-19-related ARDS.
methodsIn this prospective observational study done at two UK intensive care units, we recruited patients with ARDS due to COVID-19. Demographic, clinical, and laboratory data were collected at baseline. Plasma samples were analysed for interleukin-6 (IL-6) and soluble tumour necrosis factor receptor superfamily member 1A (TNFR1) using a novel point-of-care assay. A parsimonious regression classifier model was used to calculate the probability for the hyperinflammatory phenotype in COVID-19 using IL-6, soluble TNFR1, and bicarbonate levels. Data from this cohort was compared with patients with ARDS due to causes other than COVID-19 recruited to a previous UK multicentre, randomised controlled trial of simvastatin (HARP-2).
findingsBetween March 17 and April 25, 2020, 39 patients were recruited to the study. Median ratio of partial pressure of arterial oxygen to fractional concentration of oxygen in inspired air (PaO
interpretationIn this exploratory analysis of 39 patients, ARDS due to COVID-19 was not associated with higher systemic inflammation and was associated with a lower prevalence of the hyperinflammatory phenotype than that observed in historical ARDS data. This finding suggests that the excess mortality observed in COVID-19-related ARDS is unlikely to be due to the upregulation of inflammatory pathways described by the parsimonious model.
fundingUS National Institutes of Health, Innovate UK, and Randox.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.