The pathophysiology of 'happy' hypoxemia in COVID-19.
Respir Res
; 21(1): 198, 2020 Jul 28.
Article
in English
| MEDLINE | ID: covidwho-680693
ABSTRACT
The novel coronavirus disease 2019 (COVID-19) pandemic is a global crisis, challenging healthcare systems worldwide. Many patients present with a remarkable disconnect in rest between profound hypoxemia yet without proportional signs of respiratory distress (i.e. happy hypoxemia) and rapid deterioration can occur. This particular clinical presentation in COVID-19 patients contrasts with the experience of physicians usually treating critically ill patients in respiratory failure and ensuring timely referral to the intensive care unit can, therefore, be challenging. A thorough understanding of the pathophysiological determinants of respiratory drive and hypoxemia may promote a more complete comprehension of a patient's clinical presentation and management. Preserved oxygen saturation despite low partial pressure of oxygen in arterial blood samples occur, due to leftward shift of the oxyhemoglobin dissociation curve induced by hypoxemia-driven hyperventilation as well as possible direct viral interactions with hemoglobin. Ventilation-perfusion mismatch, ranging from shunts to alveolar dead space ventilation, is the central hallmark and offers various therapeutic targets.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Oxygen Consumption
/
Pneumonia, Viral
/
Respiratory Insufficiency
/
Coronavirus Infections
/
Pandemics
/
Betacoronavirus
/
Lung
/
Hypoxia
Type of study:
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Humans
Language:
English
Journal:
Respir Res
Year:
2020
Document Type:
Article
Affiliation country:
S12931-020-01462-5
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