Silent Hypoxia in Coronavirus disease-2019: Is it more dangerous? -A retrospective cohort study.

Autor: Sirohiya P; Department of Onco-anesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India., Elavarasi A; Department of Neurology, All India Institute of Medical Sciences, New Delhi, India., Sagiraju HKR; Department of Preventive Oncology, All India Institute of Medical Sciences, New Delhi, India., Baruah M; Department of Onco-anesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India., Gupta N; Department of Onco-anesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India., Garg RK; Department of Medicine, All India Institute of Medical Sciences, New Delhi, India., Paul SS; Department of Medicine, All India Institute of Medical Sciences, New Delhi, India., Ratre BK; Department of Onco-anesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India., Singh R; Department of Onco-anesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India., Kumar B; Department of Onco-anesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India., Vig S; Department of Onco-anesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India., Pandit A; Department of Onco-anesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India., Kumar A; Department of Onco-anesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India., Garg R; Department of Onco-anesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India., Meena VP; Department of Medicine, All India Institute of Medical Sciences, New Delhi, India., Mittal S; Department of Pulmonary Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India., Pahuja S; Department of Pulmonary Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India., Das N; Department of Laboratory Oncology, All India Institute of Medical Sciences, New Delhi, India., Dwivedi T; Department of Laboratory Oncology, All India Institute of Medical Sciences, New Delhi, India., Gupta R; Department of Laboratory Oncology, All India Institute of Medical Sciences, New Delhi, India., Kumar S; Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India., Pandey M; Department of Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India., Mishra A; Department of Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India., Matharoo KS; Department of Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India., Mohan A; Department of Pulmonary Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India., Guleria R; Department of Pulmonary Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India., Bhatnagar S; Department of Onco-anesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India.
Jazyk: angličtina
Zdroj: Lung India : official organ of Indian Chest Society [Lung India] 2022 May-Jun; Vol. 39 (3), pp. 247-253.
DOI: 10.4103/lungindia.lungindia_601_21
Abstrakt: Background: Hypoxia in patients with COVID-19 is one of the strongest predictors of mortality. Silent hypoxia is characterised by the presence of hypoxia without dyspnoea. Silent hypoxia has been shown to affect the outcome in previous studies.
Methods: This was a retrospective study of a cohort of patients with SARS-CoV-2 infection who were hypoxic at presentation. Clinical, laboratory and treatment parameters in patients with silent hypoxia and dyspnoeic hypoxia were compared. Multivariate logistic regression models were fitted to identify the factors predicting mortality.
Results: Among 2080 patients with COVID-19 admitted to our hospital, 811 patients were hypoxic with SpO 2 <94% at the time of presentation. Among them, 174 (21.45%) did not have dyspnoea since the onset of COVID-19 symptoms. Further, 5.2% of patients were completely asymptomatic for COVID-19 and were found to be hypoxic only on pulse oximetry. The case fatality rate in patients with silent hypoxia was 45.4% as compared to 40.03% in dyspnoeic hypoxic patients (P = 0.202). The odds ratio of death was 1.1 (95% CI: 0.41-2.97) in the patients with silent hypoxia after adjusting for baseline characteristics, laboratory parameters, treatment and in-hospital complications, which did not reach statistical significance (P = 0.851).
Conclusion: Silent hypoxia may be the only presenting feature of COVID-19. As the case fatality rate is comparable between silent and dyspnoeic hypoxia, it should be recognised early and treated as aggressively. Because home isolation is recommended in patients with COVID-19, it is essential to use pulse oximetry in the home setting to identify these patients.
Competing Interests: None
Databáze: MEDLINE
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