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The coronavirus disease–associated acute respiratory distress syndrome (CARDS) has characteristics familiar to classic ARDS, but it also has some unique features that have made clinicians pause when making management decisions. This editorial reviews the respiratory findings in CARDS and explores management decisions including positive end-expiratory pressure and prone positioning in the setting of relatively normal compliance early in the disease process. COVID-19 extensively impacts the organs that are best perfused because of the virus’s affinity for the internal lining of vasculature throughout the body.
CARDS needs further research for better implementation of management strategies.
– Kolene Bailey, MD
This abstract is available on the publisher's site.
The need to counter the global threat posed by corona-virus disease 2019 (COVID-19) has prompted unprec-edented hi-speed sharing of clinical data, experience, and ideas geared to first understanding and then formulating an effective approach to treatment of the coronavirus disease-associated acute respiratory distress syndrome—let us call it “CARDS.” Consistent features have quickly emerged world-wide (1, 2). Clinically, cough, and malaise and myalgias usu-ally precede by several days the first awareness of difficult breathing. Fever occurs inconsistently. Those at higher risk for deterioration are elderly and/or have preexisting hyperten-sion, diabetes, and obesity—disorders that often compromise small blood vessels. Late phase thrombosis frequently occurs. Notably, patients present to hospital at any stage of their pul-monary illness and vary in responses to standard treatment. Sudden and rapid progression occurs frequently, whereas reso-lution of CARDS is typically slow.