Silent Hypoxia in COVID-19 Patients

Silent Hypoxia in COVID-19 Patients Posted By:
...

Emergency rooms in New York are finding COVID-19 pneumonia in some patients who have no shortness of breath. Clinicians have reported that when they did x-rays or CT scans for other issues, they were finding that even patients without respiratory complaints had COVID-19 pneumonia. They found that COVID-19 pneumonia initially causes a form of oxygen deprivation called "silent hypoxia."

Normally, a patient with pneumonia will develop chest discomfort, pain with breathing, or shortness of breath. The ER physicians found that when COVID-19 pneumonia first strikes, patients don't feel short of breath, even as their oxygen levels fall. By the time they have typical pneumonia symptoms, they have alarmingly low oxygen levels and moderate to severe pneumonia on chest x-ray.

Normal oxygen saturation for most persons at sea level is between 94% and 100%. The majority of COVID-19 pneumonia patients seen in New York ERs had remarkably low oxygen saturations at triageas low as 50%!

The coronavirus attacks lung cells that make surfactant. Surfactant helps the air sacs in the lungs stay open between breaths and is critical to normal lung function. As the inflammation from COVID-19 pneumonia starts, it causes the air sacs to collapse, and oxygen levels fall. The lungs initially remain compliant, not stiff or filled with fluid. This means patients can still expel carbon dioxide and the patients do not feel short of breath. Patients compensate for the low oxygen in their blood by breathing faster and deeper.

ER clinicians recommend that all patients who have been diagnosed with COVID-19 use a pulse oximeter daily for the first 14 days of the illness to regularly check their oxygen levels. They also recommend that all persons with cough, fatigue, and fever should have pulse oximeter monitoring even if they have not had virus testing, or if they have and their swab test was negative, because the tests are only about 70 percent accurate. By doing this, patients with COVID-19 pneumonia could be identified and treated earlierbefore the lung damage is as severe. Their experience suggests by identifying and finding the patients with COVID-19 pneumonia earlier, we might be able to decrease the mortality we are now seeing across the US. Following these guidelines to help identify patients seems like a great idea to me.

References

Share

Filed under: Infectious Diseases , Pulmonary Medicine

Sign up to receive posts from The Exchange

Related
Treatment of COVID-19: Practical Questions and Insights for NPs and PAs

Treatment of COVID-19: Practical Questions and Ins ...

Is it reasonable to prescribe a 5-day supply of an oral antiviral to people traveling abroad with ri ...

Filed under: Infectious Diseases, Public Health, NPs & PAs


Continue Reading
Assessment of COVID-19: Practical Questions and Insights for NPs and PAs

Assessment of COVID-19: Practical Questions and In ...

How long should people isolate when they test positive for COVID-19?The CDC recommends that one shou ...

Filed under: Infectious Diseases, Public Health, NPs & PAs


Continue Reading
Tackling Disparities in HIV Prevention

Tackling Disparities in HIV Prevention

Racial and ethnic disparities have been a problem in the HIV epidemic since the very beginning. Rece ...

Filed under: Infectious Diseases, Women's Health, Preventive Medicine, Public Health, NPs & PAs


Continue Reading
How HIV-ASSIST Can Support NP and PA Management of Newly Diagnosed People Living with HIV

How HIV-ASSIST Can Support NP and PA Management of ...

Each year, the number of people living with HIV increases while the available HIV workforce decrease ...

Filed under: Infectious Diseases, NPs & PAs


Continue Reading
Strategies for APPs in Primary Care: Promoting PrEP Uptake Among Cisgender Women

Strategies for APPs in Primary Care: Promoting PrE ...

As a family nurse practitioner and a researcher at the University of Pennsylvania and Thomas Jeffers ...

Filed under: Infectious Diseases, Women's Health, Preventive Medicine, Public Health, NPs & PAs


Continue Reading
Monkeypox: Clinical Recognition

Monkeypox: Clinical Recognition

As healthcare providers, we have been alerted by local public healthcare agencies, healthcare instit ...

Filed under: Infectious Diseases, Public Health


Continue Reading