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Silent Hypoxia in COVID-19: A Case Series
Thomas Fuehner1,2, Isabelle Renger1, Tobias Welte2
1Department of Respiratory Medicine, Siloah Hospital, Hannover, Germany.
Respiration; International Review of Thoracic Diseases
|November 28, 2021
Summary
COVID-19 patients with hypoxemia report less shortness of breath compared to other respiratory illnesses. This study found "silent hypoxemia" was more prevalent in coronavirus disease 2019 cases.
Area of Science:
- Pulmonology
- Infectious Diseases
- Critical Care Medicine
Background:
- The COVID-19 pandemic presents significant challenges to global healthcare.
- A common yet understudied COVID-19 symptom is
- silent hypoxemia
- a mismatch between low oxygen levels and minimal respiratory distress.
Purpose of the Study:
- To investigate the sensation of dyspnea using the Borg scale in hypoxemic pulmonary patients.
- To compare dyspnea perception between COVID-19 and non-COVID-19 patients.
- To identify factors associated with "silent hypoxemia" in acute hypoxemia.
Main Methods:
- Prospective study of 82 hypoxemic pulmonary patients admitted to Siloah Hospital, Hannover, Germany.
- Dyspnea sensation was quantified using the modified Borg CR10 scale.
- Multivariate analysis was performed to identify predictors of "silent hypoxemia".
Main Results:
- COVID-19 patients (55%) reported significantly less dyspnea (median Borg CR10: 1) compared to non-COVID-19 patients (median Borg CR10: 5).
- COPD exacerbation was the most common diagnosis in the non-COVID-19 group (41%).
- "Silent hypoxemia" (Borg CR10 ≥5) was independently associated with COVID-19 (OR 0.221) and severe hypocapnia.
Conclusions:
- COVID-19 patients with acute hypoxemia experience less perceived dyspnea than non-COVID-19 patients.
- "Silent hypoxemia" is a more common clinical presentation in COVID-19.
- The findings highlight distinct respiratory symptom profiles in COVID-19 hypoxemia.
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