Publication date: May 15, 2026
Two biological subphenotypes in acute respiratory distress syndrome (ARDS) have been identified in retrospective analyses, with differential clinical outcomes and post-hoc responses to investigational treatments. The ability to identify biological subphenotypes in real-time is unknown. We aimed to evaluate the feasibility of using the multisite ISPY COVID Network to prospectively evaluate biological subphenotypes in real-time. This prospective, observational, cohort study enrolled patients with ARDS and severe acute hypoxaemic respiratory failure (AHRF) and assessed the feasibility of real-time stratification into biological subphenotypes using plasma concentrations of IL-6, soluble tumour necrosis factor-1 (TNFR1), and clinical variables. Participants were eligible if they were receiving mechanical ventilation, non-invasive positive pressure ventilation, or heated high flow nasal oxygen (at flow rates ≥30 L/min); had severe AHRF (defined by an SpO to FiO ratio ≤315, calculated with SpO ≤97%, or PaO to FiO ratio
| Concepts | Keywords |
|---|---|
| Biological | Acute |
| Retrospective | Ards |
| Tumour | Biological |
| Usa | Clinical |
| Distress | |
| Failure | |
| Hypoxaemic | |
| Observational | |
| Prospective | |
| Real | |
| Respiratory | |
| Severe | |
| Subphenotypes | |
| Syndrome | |
| Time |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | respiratory failure |
| disease | MESH | acute respiratory distress syndrome |
| drug | DRUGBANK | Oxygen |