Management of Respiratory Emergencies and Acute Respiratory Distress Syndrome (ARDS) in Emerging Infectious Diseases: A Literature Review on COVID-19
DOI:
10.29303/jbt.v25i4a.10990Published:
2025-12-16Downloads
Abstract
Emerging infectious diseases, including SARS-CoV-2, have become major global health challenges with significant clinical and social impacts. One of the most frequent and fatal complications of COVID-19 is Acute Respiratory Distress Syndrome (ARDS), characterized by impaired gas exchange due to diffuse lung injury. This study is a narrative review analyzing 28 articles on the epidemiology, pathophysiology, clinical features, and management of COVID-19 related ARDS (CARDS). The findings show that CARDS presents with greater severity and higher mortality than ARDS caused by other etiologies, driven by excessive inflammatory responses, endothelial dysfunction, and microthrombosis. Clinical manifestations progress from early COVID-19 symptoms to worsening hypoxemia in accordance with the Berlin criteria. Emergency management of COVID-19 with ARDS emphasizes the ABCDE approach, stabilization of respiratory and circulatory functions, and indication-based interventions to prevent respiratory failure and improve oxygenation. This review is expected to serve as a comprehensive reference for healthcare professionals in understanding and optimizing the management of CARDS.
Keywords:
ARDS COVID-19 Emerging infectious diseases Respiratory emergency managementReferences
Aboet, A. A., & Maskoen, T. T. (2018). Acute respiratory distress syndrome (ARDS). Anesthesia & Critical Care, 36(2), 57–63. https://macc.perdatin.org/index.php/my-journal/article/view/114
Alhazzani, W., Møller, M. H., Arabi, Y. M., Loeb, M., Gong, M. N., Fan, E., ... & Rhodes, A. (2020). Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Intensive care medicine, 46(5), 854-887. 10.1007/s00134-020-06022-5
Aslan, A., Aslan, C., Zolbanin, N. M., & Jafari, R. (2021). Acute respiratory distress syndrome in COVID-19: Possible mechanisms and therapeutic management. Pneumonia, 13(1), 14. 10.1186/s41479-021-00092-9
Baron, R. M., & Levy, B. D. (2022). Acute respiratory distress syndrome. In J. Loscalzo et al. (Eds.), Harrison’s Principles of Internal Medicine (21st ed.). McGraw-Hill Education. http://accessmedicine.mhmedical.com/content.aspx?aid=1198710091
Burhan, E., Susanto, A. D., Isbaniah, F., Nasution, S. A., Ginanjar, E., Pitoyo, C. W., Susilo, A., Firdaus, I., Santoso, A., Juzar, D. A., Arif, S. K., Lolong Wulung, N. G. H., Muchtar, F., Pulungan, A. B., Yanuarso, P. B., Sjakti, H. A., Prawira, Y., Putri, N. D., & Tim Penyusun. (2022). Pedoman tatalaksana COVID-19 (Edisi 4). PDPI, PERKI, PAPDI, PERDATIN, & IDAI.
Dhar Chowdhury, S., & Oommen, A. M. (2020). Epidemiology of COVID-19. Journal of Digestive Endoscopy, 11(1), 3–7. https://doi.org/10.1055/s-0040-1712187
Diamond, M., Peniston, H. L., Sanghavi, D. K., & Mahapatra, S. (2024). Acute respiratory distress syndrome. In StatPearls [internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK436002/
Elavarasi, R., Devi, M. A., Shanthini, K. R., & Guna, S. (2019). Emerging and re-emerging diseases. Emerging Diseases, 4(1), 59–66. https://scispace.com/pdf/emerging-and-re-emerging-disease-35w4p9xlrd.pdf
Fajgenbaum, D. C., & June, C. H. (2020). Cytokine storm. New England Journal of Medicine, 383(23), 2255–2273. https://doi.org/10.1056/nejmra2026131
Fan, E., Beitler, J. R., Brochard, L., Calfee, C. S., Ferguson, N. D., Slutsky, A. S., & Brodie, D. (2020). COVID-19-associated acute respiratory distress syndrome: is a different approach to management warranted?. The Lancet Respiratory Medicine, 8(8), 816-821.
Fatoni, A. Z., & Rakhmatullah, R. (2021). Acute respiratory distress syndrome (ARDS) in COVID-19 pneumonia. Journal of Anaesthesia and Pain, 2(1), 11–24. https://doi.org/10.21776/ub.jap.2021.002.01.02
Gibson, P. G., Qin, L., & Puah, S. H. (2020). COVID-19 acute respiratory distress syndrome (ARDS): Clinical features and differences from typical pre-COVID ARDS. Medical Journal of Australia, 213(2), 54–56.e1. https://doi.org/10.5694/mja2.50674
Hidayati, A. N. (2020). Gawat darurat medis dan bedah. Airlangga University Press.
Hui, D. S., & Zumla, A. (2019). Severe acute respiratory syndrome: Historical, epidemiologic, and clinical features. Infectious Disease Clinics of North America, 33(4), 869–889. 10.1016/j.idc.2019.07.001
Khiali, S., Khani, E., & Entezari-Maleki, T. (2020). A comprehensive review of tocilizumab in COVID-19 acute respiratory distress syndrome. Journal of Clinical Pharmacology, 60(9), 1131–1146. 10.1002/jcph.1693
Makdisi, G., & Wang, I. (2015). A review of extracorporeal membrane oxygenation (ECMO) as a lifesaving technology. Journal of Thoracic Disease, 7(7). https://jtd.amegroups.org/article/view/4753
Matthay, M. A., Arabi, Y., Arroliga, A. C., Bernard, G., Bersten, A. D., Brochard, L. J., ... & Wick, K. D. (2024). A new global definition of acute respiratory distress syndrome. American journal of respiratory and critical care medicine, 209(1), 37-47. https://doi.org/10.1164/rccm.202303-0558WS
Papazian, L., Aubron, C., Brochard, L., Chiche, J. D., Combes, A., Dreyfuss, D., ... & Faure, H. (2019). Formal guidelines: management of acute respiratory distress syndrome. Annals of intensive care, 9(1), 69. 10.1186/s13613-019-0540-9
Peng, M. (2020). Outbreak of COVID-19: An emerging global pandemic threat. Biomedicine & Pharmacotherapy, 129, 110499.
Pfortmueller, C. A., Spinetti, T., Urman, R. D., Luedi, M. M., & Schefold, J. C. (2021). COVID-19-associated acute respiratory distress syndrome (CARDS): Current knowledge on pathophysiology and ICU treatment—A narrative review. Best Practice & Research Clinical Anaesthesiology, 35(3), 351–368. 10.1016/j.bpa.2020.12.011
Pitoyo, C. W., Tenda, E. D., Akhmad, Z., Handoyo, T., Ilyas, M., & Riyanto, B. S. (2020). Review article: Kompendium diagnostik dan pengobatan COVID-19 (interim). Jurnal Penyakit Dalam Indonesia, 7(1), 17–59. http://www.indonesiajournalchest.com/index.php/IJC/issue/view/PEDOMAN_DIAGNOSTIK_DAN_PENGOBATAN_COVID-19
Pusat Krisis Kementerian Kesehatan Republik Indonesia. (2023, Juni 21). Pemantauan kasus COVID-19 Indonesia. https://pusatkrisis.kemkes.go.id/covid-19-id/
Ranieri, V. M., Rubenfeld, G. D., Thompson, B. T., et al. (2012). Acute respiratory distress syndrome: The Berlin definition. JAMA, 307(23), 2526–2533. https://doi.org/10.1001/jama.2012.5669
Saguil, A., & Fargo, M. V. (2020). Acute respiratory distress syndrome: Diagnosis and management. American Family Physician, 101(12), 730–738. https://pubmed.ncbi.nlm.nih.gov/32538594/
Sianturi, I. L., Sinatra, J., & Tambunan, R. (2021). Faktor-faktor yang mempengaruhi kematian pada pasien acute respiratory distress syndrome di ICU. Jurnal Kedokteran Methodist, 14(2), 75–83. https://ejurnal.methodist.ac.id/index.php/jkm/article/view/1342
Swenson, K. E., & Swenson, E. R. (2021). Pathophysiology of acute respiratory distress syndrome and COVID-19 lung injury. Critical care clinics, 37(4), 749. https://doi.org/10.1016/j.ccc.2021.05.001
Thim, T., Krarup, N. H. V., Grove, E. L., Rohde, C. V., & Løfgren, B. (2012). Initial assessment and treatment with the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach. International Journal of General Medicine, 117–121. 10.2147/IJGM.S28478
Zemaitis, M. R., Planas, J. H., & Waseem, M. (2017). Trauma secondary survey. In StatPearls. StatPearls Publishing.
License
Copyright (c) 2025 Ni Made Saithanya Gitanjali Dhevi, Febi Jian Setiasari, Isna Asriantin, Lale Nubya Nitzana, Hasna Tazkia Aghni
This work is licensed under a Creative Commons Attribution 4.0 International License.
Jurnal Biologi Tropis is licensed under a Creative Commons Attribution 4.0 International License.
The copyright of the received article shall be assigned to the author as the owner of the paper. The intended copyright includes the right to publish the article in various forms (including reprints). The journal maintains the publishing rights to the published articles.
Authors are permitted to disseminate published articles by sharing the link/DOI of the article at the journal. Authors are allowed to use their articles for any legal purposes deemed necessary without written permission from the journal with an acknowledgment of initial publication to this journal.
