Dynamic of SOFA Score Predicts Functionality after ARDS Therapy

Abstract Rationale: Health-related quality of life after surviving acute respiratory distress syndrome has come into focus in recent years, especially during the coronavirus disease 2019 pandemic. Objectives: A total of 143 patients with acute respiratory distress syndrome caused by COVID-19 or of other origin were recruited in a randomized multicenter trial. Methods: Clinical data during intensive care treatment and data up to 180 days after study inclusion were collected. Changes in the Sequential Organ Failure Assessment score were used to quantify disease severity. Disability was assessed using the Barthel index on days 1, 28, 90, and 180. Measurements: Mortality rate and morbidity after 180 days were compared between patients with and without COVID-19. Independent risk factors associated with high disability were identified using a binary logistic regression. Main Results: Mortality after 180 days and impairment measured by the Barthel index did not differ between patients with and without COVID-19. The SOFA score at day 5 was an independent risk factor for high disability in both groups, and score dynamic within the first 5 days significantly impacted disability in the non-COVID group. Conclusions: Acute respiratory distress syndrome caused by COVID-19 was not associated with increased mortality or morbidity. Resolution of organ dysfunction within the first 5 days significantly impacts long-term morbidity and emphasizes the importance of timely initiation of treatment in these critically ill patients.