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Scientific article
Open access
English

Temporal Changes in the Oxyhemoglobin Dissociation Curve of Critically Ill COVID-19 Patients

Published inJournal of clinical medicine, vol. 11, no. 3, 788
Publication date2022-01-31
First online date2022-01-31
Abstract

Critical COVID-19 is a life-threatening disease characterized by severe hypoxemia with complex pathophysiological mechanisms that are not yet completely understood. A pathological shift in the oxyhemoglobin curve (ODC) was previously described through the analysis of p50, intended as the oxygen tension at which hemoglobin is saturated by oxygen at 50%. The aim of this study was to analyze Hb-O2affinity features over time in a cohort of critically ill COVID-19 patients, through the analysis of ODC p50 behavior. A retrospective analysis was performed; through multiple arterial blood gas (ABG) analyses, each p50 was calculated and normalized according to PaCO2, pH and temperature; patients' p50 evolution over time was reported, comparing the first 3 days (early p50s) with the last 3 days (late p50s) of ICU stay. A total of 3514 ABG analyses of 32 consecutive patients were analyzed. The majority of patients presented a left shift over time (p= 0.03). A difference between early p50s and late p50s was found (20.63 ± 2.1 vs. 18.68 ± 3.3 mmHg,p= 0.03); median p50 of deceased patients showed more right shifts than those of alive patients (24.1 vs. 18.45 mmHg,p= 0.01). One-way ANOVA revealed a p50 variance greater in the early p50s (σ2= 8.6) than in the late p50s (σ2= 3.84), associated with a reduction over time (p< 0.001). Comparing the Hb-O2affinity in critically ill COVID-19 patients between ICU admission and ICU discharge, a temporal shift in the ODC was observed.

eng
Keywords
  • COVID-19
  • SARS-CoV-2
  • Dyspnea etiology
  • Hypoxemia
  • Hypoxia etiology
  • Oxyhemoglobin metabolism
  • Viral pneumonia
Citation (ISO format)
CERUTI, Samuele et al. Temporal Changes in the Oxyhemoglobin Dissociation Curve of Critically Ill COVID-19 Patients. In: Journal of clinical medicine, 2022, vol. 11, n° 3, p. 788. doi: 10.3390/jcm11030788
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ISSN of the journal2077-0383
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