Volume 8, Issue 2, December 2020, Page: 62-64
Prevalence of Different Severities of Hypoxia in COVID-19 Patients Admitted in Critical Care Unit
Shamim Kausar, Department of Intensive Care Unit, National Medical Centre, Karachi, Pakistan
Syeda Rida-e-Zehra, Department of Intensive Care Unit and High dependency Unit, Liaquat National Hospital and Medical College, Karachi, Pakistan
Anum Latif, Department of Intensive Care Unit and High dependency Unit, Liaquat National Hospital and Medical College, Karachi, Pakistan
Samar Abbas Jafferi, Department of Intensive Care Unit, National Medical Centre, Karachi, Pakistan; Department of Intensive Care Unit and High dependency Unit, Liaquat National Hospital and Medical College, Karachi, Pakistan
Syeda Namayah Fatima Hussain, Department of Intensive Care Unit and High dependency Unit, Liaquat National Hospital and Medical College, Karachi, Pakistan
Syeda Nazish Azim, Department of Intensive Care Unit and High dependency Unit, Liaquat National Hospital and Medical College, Karachi, Pakistan
Farah Naz, Department of Intensive Care Unit and High dependency Unit, Liaquat National Hospital and Medical College, Karachi, Pakistan
Irfan Ahsan, Department of Intensive Care Unit and High dependency Unit, Liaquat National Hospital and Medical College, Karachi, Pakistan
Pirih Bhatti, Department of Intensive Care Unit and High dependency Unit, Liaquat National Hospital and Medical College, Karachi, Pakistan
Received: Sep. 20, 2020;       Accepted: Sep. 30, 2020;       Published: Oct. 13, 2020
DOI: 10.11648/j.ijacm.20200802.16      View  9      Downloads  8
Abstract
In 2020 Corona Virus Disease 2019 (COVID-19) infection hit the world as pandemic. The most common and life threatening complication was various severity of respiratory failure. So we decided to conduct a study to determine the prevalence of different severities of hypoxia in COVID-19 infection. The study was a cross sectional prospective observational study on 50 participants. The study was conducted in COVID Intensive care unit (ICU) of Liaquat National Hospital and Medical College and COVID ICU of National Medical Centre Karachi, Pakistan. All patients with PO2 to FiO2 (PF) ratio less than 300, smokers and non-smokers were included in the study. PF ratio of 300 to 200 was considered as mild, 200 to 100 as Moderate and less than 100 considered as severe hypoxia. Admitting PO2 from an Arterial Blood Gas (ABG) sample and FIO2 was noted. Prevalence of hypoxia severities were graded, need of mechanical ventilation and mortality of each group was determined. 42 (84%) of patients had severe while 8 patients 16% had moderate hypoxia. None of the patient admitted in critical care had mild hypoxia. In severely hypoxic patients mortality rate was 28.6% and in moderately hypoxic group it was 50%. Severe hypoxia effected most of the COVID-19 infected patients admitted in critical care, which may be the cause of poor outcomes in critically ill COVID-19 patients.
Keywords
Hypoxia, Critical Care, COVID-19, Acute respiratory Distress Syndrome, Mechanical Ventilation
To cite this article
Shamim Kausar, Syeda Rida-e-Zehra, Anum Latif, Samar Abbas Jafferi, Syeda Namayah Fatima Hussain, Syeda Nazish Azim, Farah Naz, Irfan Ahsan, Pirih Bhatti, Prevalence of Different Severities of Hypoxia in COVID-19 Patients Admitted in Critical Care Unit, International Journal of Anesthesia and Clinical Medicine. Vol. 8, No. 2, 2020, pp. 62-64. doi: 10.11648/j.ijacm.20200802.16
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China [published correction appears in Lancet. 2020 Jan 30;]. Lancet. 2020; 395 (10223): 497-506. doi: 10.1016/S0140-6736(20)30183-5.
[2]
World Health Organization (WHO) WHO; Geneva, Switzerland: 2020. Coronavirus disease 2019 (COVD-19). Situation report – 209 https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200816-covid-19-sitrep-209.pdf?sfvrsn=5dde1ca2_2 [accessed 27 August 2020].
[3]
Guan W. J., Ni Z. Y., Hu Y., Liang W. H., Ou C. Q., He J. X. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020 Feb 28 doi: 10.1056/NEJMoa2002032.
[4]
Lai C. C., Shih T. P., Ko W. C., Tang H. J., Hsueh P. R. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): the epidemic and the challenges. Int J Antimicrob Agents. 2020; 55 doi: 10.1016/j.ijantimicag.2020.105924.
[5]
Lai C. C., Liu Y. H., Wang C. Y., Wang Y. H., Hsueh S. C., Yen M. Y. Asymptomatic carrier state, acute respiratory disease, and pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): facts and myths. J Microbiol Immunol Infect. 2020 March 4 doi: 10.1016/j.jmii.2020.02.012.
[6]
Lai CC, Wang CY, Wang YH, Hsueh SC, Ko WC, Hsueh PR. Global epidemiology of coronavirus disease 2019 (COVID-19): disease incidence, daily cumulative index, mortality, and their association with country healthcare resources and economic status. Int J Antimicrob Agents. 2020; 55 (4): 105946. doi: 10.1016/j.ijantimicag.2020.105946.
[7]
Carlos W. G., Dela C., Cao B., Pasnick S. (2019-nCoV) coronavirus. Am J Respir Crit Care Med. 2020; 201 (4): 7–8. doi: 10.1164/rccm.2014P7.
[8]
Ellul M, Benjamin L, Singh B, et al. Neurological associations of COVID-19. Lancet Neurol 2020; S1474-4422 (20) 30221-0. https://doi.org/10.1016/S1474-4422(20)30221-0.
[9]
Villapol S. Gastrointestinal symptoms associated with COVID-19: impact on the gut microbiome [published online ahead of print, 2020 Aug 19]. Transl Res. 2020; S1931-5244(20)30199-7. doi: 10.1016/j.trsl.2020.08.004.
[10]
Lang M, Som A, Carey D, et al. Pulmonary Vascular Manifestations of COVID-19 Pneumonia. Radiol Cardiothorac Imaging. 2020; 2 (3): e200277. Published 2020 Jun 18. doi: 10.1148/ryct.2020200277.
[11]
Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020; 395 (10229): 1033–1034. doi: 10.1016/S0140-6736(20)30628-0.
[12]
Shebl E, Burns B. Respiratory Failure. [Updated 2020 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526127/.
[13]
Kapil S, Wilson JG. Mechanical Ventilation in Hypoxemic Respiratory Failure. Emerg Med Clin North Am. 2019; 37 (3): 431-444. doi: 10.1016/j.emc.2019.04.005.
[14]
The Respiratory System Vol. II. Control of Breathing. Part 1. Bethesda, MD: American Physiological Society; 1986: 395-429.
[15]
Lamba TS, Sharara RS, Singh AC, Balaan M. Pathophysiology and Classification of Respiratory Failure. Crit Care Nurs Q. 2016; 39 (2): 85-93. doi: 10.1097/CNQ.0000000000000102.
[16]
Esan A, Hess DR, Raoof S, George L, Sessler CN. Severe hypoxemic respiratory failure: part 1--ventilatory strategies. Chest. 2010; 137 (5): 1203-1216. doi: 10.1378/chest.09-2415.
[17]
Raoof S, Goulet K, Esan A, Hess DR, Sessler CN. Severe hypoxemic respiratory failure: part 2--nonventilatory strategies. Chest. 2010; 137 (6): 1437-1448. doi: 10.1378/chest.09-2416.
[18]
Narendra DK, Hess DR, Sessler CN, et al. Update in Management of Severe Hypoxemic Respiratory Failure. Chest. 2017; 152 (4): 867-879. doi: 10.1016/j.chest.2017.06.039.
[19]
David-João PG, Guedes MH, Réa-Neto Á, Chaiben VBO, Baena CP. Noninvasive ventilation in acute hypoxemic respiratory failure: A systematic review and meta-analysis. J Crit Care. 2019; 49: 84-91. doi: 10.1016/j.jcrc.2018.10.012.
[20]
Dhont, S., Derom, E., Van Braeckel, E. et al. The pathophysiology of ‘happy’ hypoxemia in COVID-19. Respir Res 21, 198 (2020). https://doi.org/10.1186/s12931-020-01462-5.
[21]
Couzin-Frankel J. The mystery of the pandemic's 'happy hypoxia'. Science. 2020; 368 (6490): 455-456. doi: 10.1126/science.368.6490.455.
[22]
U R A, Verma K. Happy Hypoxemia in COVID-19-A Neural Hypothesis. ACS Chem Neurosci. 2020; 11 (13): 1865-1867. doi: 10.1021/acschemneuro.0c00318.
[23]
Hensel M, Strunden MS, Tank S, Gagelmann N, Wirtz S, Kerner T. Prehospital non-invasive ventilation in acute respiratory failure is justified even if the distance to hospital is short. Am J Emerg Med. 2019 Apr; 37 (4): 651-656.
[24]
Reddy, RK, Charles, WN, Sklavounos, A, Dutt, A, Seed, PT, Khajuria, A. The effect of smoking on COVID-19 severity: A systematic review and meta-analysis. J Med Virol. 2020; 1– 12. https://doi.org/10.1002/jmv.26389.
[25]
Berlin I, Thomas D, Le Faou AL, Cornuz J. COVID-19 and Smoking. Nicotine Tob Res. 2020; 22 (9): 1650-1652. doi: 10.1093/ntr/ntaa059.
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