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Silent Hypoxia in Coronavirus disease-2019: Is it more dangerous? -A retrospective cohort study
BACKGROUND: Hypoxia in patients with COVID-19 is one of the strongest predictors of mortality. Silent hypoxia is characterised by the presence of hypoxia without dyspnoea. Silent hypoxia has been shown to affect the outcome in previous studies. METHODS: This was a retrospective study of a cohort of...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9200195/ https://www.ncbi.nlm.nih.gov/pubmed/35488682 http://dx.doi.org/10.4103/lungindia.lungindia_601_21 |
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author | Sirohiya, Prashant Elavarasi, Arunmozhimaran Sagiraju, Hari Krishna Raju Baruah, Madhusmita Gupta, Nishkarsh Garg, Rohit Kumar Paul, Saurav Sekhar Ratre, Brajesh Kumar Singh, Ram Kumar, Balbir Vig, Saurabh Pandit, Anuja Kumar, Abhishek Garg, Rakesh Meena, Ved Prakash Mittal, Saurabh Pahuja, Saurabh Das, Nupur Dwivedi, Tanima Gupta, Ritu Kumar, Sunil Pandey, Manisha Mishra, Abhinav Matharoo, Karanvir Singh Mohan, Anant Guleria, Randeep Bhatnagar, Sushma |
author_facet | Sirohiya, Prashant Elavarasi, Arunmozhimaran Sagiraju, Hari Krishna Raju Baruah, Madhusmita Gupta, Nishkarsh Garg, Rohit Kumar Paul, Saurav Sekhar Ratre, Brajesh Kumar Singh, Ram Kumar, Balbir Vig, Saurabh Pandit, Anuja Kumar, Abhishek Garg, Rakesh Meena, Ved Prakash Mittal, Saurabh Pahuja, Saurabh Das, Nupur Dwivedi, Tanima Gupta, Ritu Kumar, Sunil Pandey, Manisha Mishra, Abhinav Matharoo, Karanvir Singh Mohan, Anant Guleria, Randeep Bhatnagar, Sushma |
author_sort | Sirohiya, Prashant |
collection | PubMed |
description | BACKGROUND: Hypoxia in patients with COVID-19 is one of the strongest predictors of mortality. Silent hypoxia is characterised by the presence of hypoxia without dyspnoea. Silent hypoxia has been shown to affect the outcome in previous studies. METHODS: This was a retrospective study of a cohort of patients with SARS-CoV-2 infection who were hypoxic at presentation. Clinical, laboratory and treatment parameters in patients with silent hypoxia and dyspnoeic hypoxia were compared. Multivariate logistic regression models were fitted to identify the factors predicting mortality. RESULTS: Among 2080 patients with COVID-19 admitted to our hospital, 811 patients were hypoxic with SpO(2) <94% at the time of presentation. Among them, 174 (21.45%) did not have dyspnoea since the onset of COVID-19 symptoms. Further, 5.2% of patients were completely asymptomatic for COVID-19 and were found to be hypoxic only on pulse oximetry. The case fatality rate in patients with silent hypoxia was 45.4% as compared to 40.03% in dyspnoeic hypoxic patients (P = 0.202). The odds ratio of death was 1.1 (95% CI: 0.41–2.97) in the patients with silent hypoxia after adjusting for baseline characteristics, laboratory parameters, treatment and in-hospital complications, which did not reach statistical significance (P = 0.851). CONCLUSION: Silent hypoxia may be the only presenting feature of COVID-19. As the case fatality rate is comparable between silent and dyspnoeic hypoxia, it should be recognised early and treated as aggressively. Because home isolation is recommended in patients with COVID-19, it is essential to use pulse oximetry in the home setting to identify these patients. |
format | Online Article Text |
id | pubmed-9200195 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-92001952022-06-16 Silent Hypoxia in Coronavirus disease-2019: Is it more dangerous? -A retrospective cohort study Sirohiya, Prashant Elavarasi, Arunmozhimaran Sagiraju, Hari Krishna Raju Baruah, Madhusmita Gupta, Nishkarsh Garg, Rohit Kumar Paul, Saurav Sekhar Ratre, Brajesh Kumar Singh, Ram Kumar, Balbir Vig, Saurabh Pandit, Anuja Kumar, Abhishek Garg, Rakesh Meena, Ved Prakash Mittal, Saurabh Pahuja, Saurabh Das, Nupur Dwivedi, Tanima Gupta, Ritu Kumar, Sunil Pandey, Manisha Mishra, Abhinav Matharoo, Karanvir Singh Mohan, Anant Guleria, Randeep Bhatnagar, Sushma Lung India Original Article BACKGROUND: Hypoxia in patients with COVID-19 is one of the strongest predictors of mortality. Silent hypoxia is characterised by the presence of hypoxia without dyspnoea. Silent hypoxia has been shown to affect the outcome in previous studies. METHODS: This was a retrospective study of a cohort of patients with SARS-CoV-2 infection who were hypoxic at presentation. Clinical, laboratory and treatment parameters in patients with silent hypoxia and dyspnoeic hypoxia were compared. Multivariate logistic regression models were fitted to identify the factors predicting mortality. RESULTS: Among 2080 patients with COVID-19 admitted to our hospital, 811 patients were hypoxic with SpO(2) <94% at the time of presentation. Among them, 174 (21.45%) did not have dyspnoea since the onset of COVID-19 symptoms. Further, 5.2% of patients were completely asymptomatic for COVID-19 and were found to be hypoxic only on pulse oximetry. The case fatality rate in patients with silent hypoxia was 45.4% as compared to 40.03% in dyspnoeic hypoxic patients (P = 0.202). The odds ratio of death was 1.1 (95% CI: 0.41–2.97) in the patients with silent hypoxia after adjusting for baseline characteristics, laboratory parameters, treatment and in-hospital complications, which did not reach statistical significance (P = 0.851). CONCLUSION: Silent hypoxia may be the only presenting feature of COVID-19. As the case fatality rate is comparable between silent and dyspnoeic hypoxia, it should be recognised early and treated as aggressively. Because home isolation is recommended in patients with COVID-19, it is essential to use pulse oximetry in the home setting to identify these patients. Wolters Kluwer - Medknow 2022 2022-04-20 /pmc/articles/PMC9200195/ /pubmed/35488682 http://dx.doi.org/10.4103/lungindia.lungindia_601_21 Text en Copyright: © 2022 Indian Chest Society https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Sirohiya, Prashant Elavarasi, Arunmozhimaran Sagiraju, Hari Krishna Raju Baruah, Madhusmita Gupta, Nishkarsh Garg, Rohit Kumar Paul, Saurav Sekhar Ratre, Brajesh Kumar Singh, Ram Kumar, Balbir Vig, Saurabh Pandit, Anuja Kumar, Abhishek Garg, Rakesh Meena, Ved Prakash Mittal, Saurabh Pahuja, Saurabh Das, Nupur Dwivedi, Tanima Gupta, Ritu Kumar, Sunil Pandey, Manisha Mishra, Abhinav Matharoo, Karanvir Singh Mohan, Anant Guleria, Randeep Bhatnagar, Sushma Silent Hypoxia in Coronavirus disease-2019: Is it more dangerous? -A retrospective cohort study |
title | Silent Hypoxia in Coronavirus disease-2019: Is it more dangerous? -A retrospective cohort study |
title_full | Silent Hypoxia in Coronavirus disease-2019: Is it more dangerous? -A retrospective cohort study |
title_fullStr | Silent Hypoxia in Coronavirus disease-2019: Is it more dangerous? -A retrospective cohort study |
title_full_unstemmed | Silent Hypoxia in Coronavirus disease-2019: Is it more dangerous? -A retrospective cohort study |
title_short | Silent Hypoxia in Coronavirus disease-2019: Is it more dangerous? -A retrospective cohort study |
title_sort | silent hypoxia in coronavirus disease-2019: is it more dangerous? -a retrospective cohort study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9200195/ https://www.ncbi.nlm.nih.gov/pubmed/35488682 http://dx.doi.org/10.4103/lungindia.lungindia_601_21 |
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