Daily Ards Research Analysis

IMPORTANCE: Respiratory syncytial virus (RSV) vaccines for adults aged 60 years or older became available in 2023. One dose is recommended for all adults aged 75 years or older and those aged 60 to 74 years at increased risk of severe RSV; however, duration of protection is unknown. OBJECTIVE: To evaluate RSV vaccine effectiveness against RSV-associated hospitalization among adults aged 60 years or older during 2 RSV seasons. DESIGN, SETTING, AND PARTICIPANTS: A total of 6958 adults aged 60 years or older were included in this test-negative, case-control study if they were hospitalized with acute respiratory illness at any of 26 hospitals in 20 US states during the October 1, 2023, to March 31, 2024, or October 1, 2024, to April 30, 2025, RSV seasons and had respiratory virus testing within 10 days of illness onset. Case patients tested positive for RSV only; control patients tested negative for RSV, SARS-CoV-2, and influenza. Demographic and clinical data were obtained through patient interview and electronic health records. EXPOSURES: Receipt of 1 RSV vaccine dose at least 14 days before illness onset. MAIN OUTCOMES AND MEASURES: Multivariable logistic regression was used to compare the odds of RSV vaccination among hospitalized cases and controls. Models were adjusted for age, sex, race and ethnicity, geographic region, and calendar month and year. Vaccine effectiveness was estimated as (1 - adjusted odds ratio) × 100%. Analyses were stratified by timing of RSV vaccine receipt (same vs prior season) relative to illness onset. RESULTS: Of 6958 adults aged 60 years or older, 821 (11.8%) were RSV cases and 6137 (88.2%) were controls. A total of 1438 patients were Black (20.1%) and 4314 were White (62.0%); 3534 were female (50.8%). Median age was 72 years (IQR, 66-80 years) and 1829 adults (26.3%) were immunocompromised. A total of 63 cases (7.7%) and 966 controls (15.7%) were vaccinated. Estimated vaccine effectiveness against RSV-associated hospitalization was 58% (95% CI, 45%-68%) during 2 seasons and 69% (95% CI, 52%-81%) for same-season vaccination vs 48% (95% CI, 27%-63%; P = .06) for prior-season vaccination. Estimated vaccine effectiveness during 2 seasons was significantly lower among immunocompromised adults (30%; 95% CI, -9% to 55%) than immunocompetent adults (67%; 95% CI, 53%-77%; P = .02) and among those with cardiovascular disease (56%; 95% CI, 32%-72%) vs without (80%; 95% CI, 62%-90%; P = .03). CONCLUSIONS AND RELEVANCE: Respiratory syncytial virus vaccines prevented RSV-associated hospitalization during 2 seasons, although effectiveness was lower in patients with immunocompromise and cardiovascular disease than in those without these conditions. Ongoing monitoring is needed to determine the optimal RSV revaccination interval.

BACKGROUND: Inflammation caused by ongoing sepsis stimulation significantly contributes to immunosuppression. However, the alterations in lymphocyte subsets and transcriptome profiles in the development of sepsis-induced acute respiratory distress syndrome (ARDS) remain unclear. METHODS: Peripheral blood mononuclear cells were collected from patients with sepsis at various points after admission. RNA sequencing was utilized to investigate the transcriptional changes in sepsis patients with and without ARDS. The immune cell composition of patients was dynamically monitored using flow cytometry. The comparisons were made between the changes in T cell subsets in sepsis patients without ARDS and those who developed ARDS during their hospitalization. Furthermore, the authors continuously tracked CD8 RESULTS: There were significant transcriptome gene differences between sepsis patients with and without ARDS. According to KEGG enrichment analysis, most of the differentially expressed genes between these patients were connected to infection, immunological response, cell proliferation, and death. Additional GO enrichment analysis revealed that many genes were linked to T-cell activation, proliferation, and growth. Compared with sepsis patients without ARDS, the number and percentage of lymphocytes, especially CD8 CONCLUSION: Sepsis patients with and without ARDS exhibit markedly different genes and immune cells. Patients with ARDS typically exhibited reduced CD8

BACKGROUND: The prognosis of patients with a concomitance of severe traumatic brain injury (sTBI) and acute respiratory distress syndrome (ARDS) is poor, and early identification of such patients can provide diagnostic and therapeutic assistance for clinical treatment. However, few studies have been conducted to identify the risk of ARDS in patients with sTBI. This study aimed to construct a risk prediction model for ARDS in patients with sTBI and evaluate its efficacy. METHODS: From 2016 to 2023, 502 patients diagnosed with sTBI were selected from the Affiliated Hospital of Yangzhou University. All participants were randomly allocated to either the training or validation group. Feature selection for constructing the prediction model and developing a nomogram was carried out using the least absolute shrinkage and selection operator (LASSO) and multivariable logistic regression analysis. The effectiveness and clinical relevance of the model were evaluated using receiver operating characteristic (ROC) curves, the area under the ROC curve (AUC), calibration curves, and the decision curve analysis (DCA). RESULTS: The study found that 32.9% of patients with sTBI developed ARDS. The model was established based on oxygen saturation measured by pulse oximetry (SpO CONCLUSIONS: The diagnostic nomogram for ARDS in sTBI patients demonstrated satisfactory predictive value, assisting clinicians in identifying high-risk patients for ARDS. TRAIL REGISTRATION: ChiCTR2400085916.