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Silent Hypoxia in COVID-19: A Case Series.
Fuehner, Thomas; Renger, Isabelle; Welte, Tobias; Freundt, Tobias; Gottlieb, Jens.
  • Fuehner T; Department of Respiratory Medicine, Siloah Hospital, Hannover, Germany.
  • Renger I; Dept of Respiratory Medicine and German Centre for Lung Research (DZL/BREATH), Hannover Medical School, Hannover, Germany.
  • Welte T; Department of Respiratory Medicine, Siloah Hospital, Hannover, Germany.
  • Freundt T; Dept of Respiratory Medicine and German Centre for Lung Research (DZL/BREATH), Hannover Medical School, Hannover, Germany.
  • Gottlieb J; Department of Respiratory Medicine, Siloah Hospital, Hannover, Germany.
Respiration ; 101(4): 376-380, 2022.
Article in English | MEDLINE | ID: covidwho-1538006
ABSTRACT

BACKGROUND:

The coronavirus disease 2019 (COVID-19) pandemic is an ongoing global crisis challenging the worldwide healthcare systems. Many patients present with a mismatch of profound hypoxemia and few signs of respiratory distress (i.e., silent hypoxemia). This particular clinical presentation is often cited, but data are limited. MAIN BODY We describe dyspnea sensation as assessed by using the BORG scale in pulmonary patients admitted to the emergency room during a 4-week period and transferred to the respiratory department of Siloah Hospital, Hannover, Germany. From October 1 to November 1, 2020, 82 patients with hypoxemia defined as oxygen demand to achieve an oxygen saturation (SpO2) ≥92% were included. In 45/82 (55%) patients, SARS-CoV-2 was detected by PCR on admission. Among non-COVID patients, exacerbation of COPD was the main diagnosis (15/37, 41%). All subjects rated their perceived dyspnea using the modified Borg CR10 scale. Patients in the non-COVID group suffered from more dyspnea on the modified Borg CR10 scale (median 1, IQR 0-2 vs. median 5, IQR 3-6, p < 0.001). In multivariate analysis, "silent hypoxemia" as defined by the dyspnea Borg CR10 scale ≥5 was independently associated with COVID-19 and presence of severe hypocapnia with an odds ratio of 0.221 (95% confidence interval 0.054, 0.907, p 0.036).

CONCLUSION:

Among pulmonary patients with acute hypoxemia defined as oxygen demand, patients suffering from COVID-19 experience less dyspnea compared to non-COVID patients. "Silent" hypoxemia was more common in COVID-19 patients.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Respiration Year: 2022 Document Type: Article Affiliation country: 000520083

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Respiration Year: 2022 Document Type: Article Affiliation country: 000520083