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Silent hypoxemia in a patient with severe SARS-CoV-2 pneumonia

https://doi.org/10.47093/2218-7332.2020.11.2.87-91

Abstract

Patients with COVID-19 are typically characterized by severe lung injury with the development of acute respiratory failure. However, in some patients, subjective well-being may remain relatively satisfactory for a long time and, despite severe hypoxemia, they do not complain of shortness of breath.

Case report. We observed a 65-year-old man hospitalized with severe SARS-CoV-2 pneumonia, low level of blood oxygen saturation, but at the same time without complaints of shortness of breath. Only as the disease progressed with a decrease in oxygen saturation when breathing atmospheric air (SpO2 ) lower than 85% he began to notice a feeling of lack of air. The patient’s condition worsened and as a result, he died in the intensive care unit from multiple organ failure.

Discussion. This case clearly illustrates one more feature of the course of pneumonia associated with the novel SARSCoV-2 coronavirus and shows that SpO2 measurement is one of the leading objective criterion that allows a doctor to assess the real severity of a patient’s condition with COVID-19.

About the Authors

A. D. Palman
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Alexander D. Palman, MD, PhD, Associate Professor, Department of Hospital Therapy No. 1

8/2, Trubetskaya str., Moscow, 119991



D. A. Andreev
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Denis A. Andreev, MD, PhD, DMSc, Professor, Head of the Department of Cardiology, Functional and Ultrasound Diagnostics

8/2, Trubetskaya str., Moscow, 119991



S. A. Suchkova
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Svetlana A. Suchkova, cardiologist, Cardiology Department for patients with myocardial infarction, University Clinical Hospital No. 1

8/2, Trubetskaya str., Moscow, 119991



References

1. Zhu N., Zhang D., Wang W., et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020 Feb; 382(8): 727–33. https://doi.org/10.1056/NEJMoa2001017 PMID: 31978945

2. WHO Director-General’s opening remarks at the media briefing on COVID-19 11 March 2020. URL: https://www.who.int/ dg/speeches/detail/who-director-general-s-opening-remarksat-the-media-briefing-on-covid-19---11-march-2020 (accessed 15.06.2020).

3. Wu Z., McGoogan J.M. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020; 323(13): 1239–42. https://doi.org/10.1001/jama.2020.2648 PMID: 32091533

4. Glybochko P.V., Fomin V.V., Avdeev S.N., et al. Klinicheskaya kharakteristika 1007 bol’nykh tyazheloi SARSCoV-2 pnevmoniei, nuzhdavshikhsya v respiratornoi podderzhke. [Clinical characteristics of 1007 intensive care unit patients with SARS-CoV-2 pneumonia]. Klinicheskaya farmakologiya i terapiya. 2020; 29(2): 21–9 (In Russian). https://doi.org/10.32756/0869-5490-2020-2-21-29

5. Tobin M.J., Laghi F., Jubran A. Why COVID-19 Silent Hypoxemia Is Baffling to Physicians. Am. J. Respir. Crit. Care Med. 2020. 202(3):356–60. https://doi.org/10.1164/rccm.202006-2157CP PMID: 32539537

6. Wilkerson R.G., Adler J.D., Shah N.G., Brown R. Silent hypoxia: A harbinger of clinical deterioration in patients with COVID-19. Am. J. Emerg. Med. 2020 May 22. https://doi.org/10.1016/j. ajem.2020.05.044 PMID: 32471783

7. Intensivnaya terapiya v pul’monologii [Intensive therapy in pulmonology]. Edited by S.N. Avdeev ed. Vol. 1. Moscow: Atmosphere, 2014. 304 p. (In Russian).

8. Jouffroy R., Jost D., Prunet B. Prehospital pulse oximetry: a red flag for early detection of silent hypoxemia in COVID-19 patients. Crit Care. 2020 Jun; 24(1): 313–4. https://doi.org/10.1186/ s13054-020-03036-9 PMID: 32513249


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ISSN 2218-7332 (Print)
ISSN 2658-3348 (Online)