Characteristics and predictors for silent hypoxemia in a cohort of hospitalized COVID-19 patients
| Autor: | Osvaldo Alexis Marché-Fernández, Anaclara Michel-Chávez, Alma Poema Vigueras-Hernández, Carlos Cantú-Brito, Erwin Chiquete, Miguel García-Grimshaw, Oswaldo Alan Chávez-Martínez, Rogelio Domínguez-Moreno, Fernando Flores-Silva, Samantha Sánchez-Torres, Alejandra González-Duarte |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Hemodynamics Article Hypoxemia Cellular and Molecular Neuroscience Interquartile range Internal medicine Medicine Humans Prospective Studies Prospective cohort study Hypoxia Oxygen saturation (medicine) Inpatients Endocrine and Autonomic Systems business.industry SARS-CoV-2 COVID-19 Emergency department Hypoxia (medical) Middle Aged respiratory tract diseases Hospitalization Dyspnea Happy hypoxemia Cohort Silent hypoxemia Female Neurology (clinical) medicine.symptom business |
| Zdroj: | Autonomic Neuroscience |
| ISSN: | 1872-7484 1566-0702 |
| Popis: | Background An intriguing feature recently unveiled in some COVID-19 patients is the “silent hypoxemia” phenomenon, which refers to the discrepancy of subjective well-being sensation while suffering hypoxia, manifested as the absence of dyspnea. Objective To describe the clinical characteristics and predictors of silent hypoxemia in hospitalized COVID-19 patients. Methods We conducted a prospective cohort study including consecutive hospitalized adult (≥ 18 years) patients with confirmed COVID-19 presenting to the emergency department with oxygen saturation (SpO2) ≤ 80% on room air from March 15 to June 30, 2020. We analyzed the characteristics, disease severity, and in-hospital outcomes of patients presenting with dyspnea and those without dyspnea (silent hypoxemia). Results We studied 470 cases (64.4% men; median age 55 years, interquartile range 46–64). There were 447 (95.1%) patients with dyspnea and 23 (4.9%) with silent hypoxemia. The demographic and clinical characteristics, comorbidities, laboratory and imaging findings, disease severity, and outcomes were similar between groups. Higher breathing and heart rates correlated significantly with lower SpO2 in patients with dyspnea but not in those with silent hypoxemia. Independent predictors of silent hypoxemia were the presence of new-onset headache (OR 2.919, 95% CI 1.101–7.742; P = 0.031) and presenting to the emergency department within the first eight days after symptoms onset (OR 3.183, 95% CI 1.024–9.89; P = 0.045). Conclusions Patients with silent hypoxemia sought medical attention earlier and had new-onset headache more often. They were also likely to display lower hemodynamic compensatory responses to hypoxemia, which may underestimate the disease severity. |
| Databáze: | OpenAIRE |
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