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Breathlessness and COVID-19: A Call for Research
Lisa Hentsch1, Sara Cocetta2, Gilles Allali3,4
1Division of Palliative Medicine, Geneva University Hospitals, Geneva, Switzerland.
Respiration; International Review of Thoracic Diseases
|August 1, 2021
Summary
COVID-19 patients may not perceive breathlessness due to cerebral complications affecting brain-lung interactions. This review explores altered breathlessness perception in COVID-19, examining silent hypoxemia and its neurological underpinnings.
Area of Science:
- Neurology
- Pulmonology
- Infectious Diseases
Background:
- Breathlessness (dyspnoea) is a common, debilitating symptom.
- COVID-19 is associated with neurological complications, including encephalopathy.
- Some COVID-19 patients exhibit "silent hypoxemia" with reduced breathlessness perception.
Purpose of the Study:
- To review mechanisms of breathlessness.
- To summarize COVID-19 pathophysiology and brain-lung interactions.
- To hypothesize on altered breathlessness perception in COVID-19.
Main Methods:
- Literature review of breathlessness mechanisms.
- Analysis of COVID-19 pathophysiology and neurological effects.
- Synthesis of existing data on brain-lung interaction in COVID-19.
Main Results:
- COVID-19 encephalopathy may impair processing of breathlessness signals.
- Altered brain-lung interaction could explain "silent hypoxemia".
- Discrepancy between disease severity and perceived dyspnoea is noted.
Conclusions:
- COVID-19's cerebral effects may alter breathlessness perception.
- Further research is needed to understand this phenomenon.
- Understanding these mechanisms is crucial for patient management.
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