Background: Leptospirosis, a spirochete infection, causes significant mortality in endemic areas. Disease progression is rapid if not treated. Acute Respiratory Distress Syndrome (ARDS) and hemoptysis lead to need for intensive ventilatory care and blood products in nearly all patients. Newer treatment modalities are under trial, but are not proven to have significant effect.

Objectives: To study the duration of symptoms, clinical presentation, use of peptides, cure rate and duration of admission in patients with Leptospirosis ARDS.

Methods: Leptospirosis ARDS cases from Jan 2020 to Dec 2023 were identified & analysed for demographic data, clinical details, & outcomes.

Result: 108 Leptospirosis ARDS patients were seen in 4-year period (mean ? 27 cases/year), with average age of 33.5 years. There were 24 females and 84 males. Patients presented after mean symptom duration of 2.4 days. Dyspnea, Fever and Cough were most common symptoms. On admission SOFA score averaged 7.4 points. 32 patients were given 3 doses of Aviptadil. The overall mortality was 26.8%, with that in Aviptadil group being 28.1%. Patients who survived had average SOFA score of 6.0 points, with those receiving Aviptadil averaging SOFA score of 6.7 points. The average duration of admission amongst survivors was 9.5 days, with Aviptadil receiving survivors having admission duration averaging 12 days.

Conclusions: Early diagnosis is crucial in management of hemorrhagic ARDS in Leptospirosis, which has a significant mortality in Intensive Care settings. Aviptadil does not affect overall mortality, but it significantly improves survival in more severe patients (according to SOFA score), with an increase in the duration of admission.