Acute respiratory failure mortality increases in United States and may worsen with COVID-19 pandemic
A new study published in Chest by University of Alabama at Birmingham researchers showed that deaths related to acute respiratory failure are increasing in the United States, while mortality due to acute respiratory distress syndrome has shown a lack of decline in last five years. The death rates were highest among older individuals (≥65 years), non-Hispanic Blacks, those living in the non-metropolitan regions and in the Southern United States.
Vibhu Parcha, M.D., a clinical research fellow in the Division of Cardiovascular Disease, says this study was a deep dive into the current trends and geographic variation in deaths due to acute respiratory failure and ARDS in the United States. Severe COVID-19 patients frequently develop acute respiratory failure necessitating admission to intensive care settings. ARDS is the primary cause of death among patients with COVID-19.
In this study, Parcha and his team analyzed the nationwide mortality data from the Centers for Disease Control and Prevention's mortality database, which incorporates the cause-specific mortality data for all Americans. This investigation by UAB researchers highlighted some key disparities in deaths due to acute respiratory failure and ARDS.
"We observed a worrying trend of an approximately 3 percent annual increase in mortality due to acute respiratory failure in the United States in the last five years," Parcha explained. "Additionally, we noted that deaths due to ARDS, a fatal lung condition, which had been declining in the early 2000s, has now become stagnant. We saw that Southern states, especially Alabama, have been doing poorly when it comes to these mortality rates. The mortality due to acute respiratory failure and ARDS was higher in the rural areas and among non-Hispanic Blacks. Most of the deaths due to acute respiratory failure were related to influenza and pneumonia, and the deaths increased during the winter months."
The investigation revealed some key areas of health disparities among people dying due to acute respiratory failure and ARDS. COVID-19 is another infection that contributes to the mortality burden due to acute respiratory failure and ARDS.
"In our study every year, we saw an increase in the mortality during the winter months, which overlapped with the influenza season," said senior author Pankaj Arora, M.D., a physician-scientist in UAB's Division of Cardiovascular Disease. "This is especially concerning since we are headed into the dreadful flu season in the midst of a pandemic. The Southern states, individuals from rural areas and racial minorities now face a double whammy. There are existing disparities in death due to ARDS in these populations, which is likely to worsen during the flu season in the setting of the current pandemic."
Arora added that the study has highlighted the urgent need to invest in improving critical care health services, especially in these areas of disparities.
"The health care system is already burdened, and the pandemic is crushing it further," Arora said. "This is especially important now that we are seeing a spike in COVID-19 cases, especially in the same regions that have a high ARDS mortality burden."
Arora hopes the study findings can help guide policymakers and federal agencies in resource allocation and pandemic control.
"It is important for us not to take this pandemic lightly," Arora said. "These are understandably difficult times, and if we are resilient in our efforts by adhering obediently to the CDC's recommendations, we can keep our families and communities safe."