A left shift in the oxyhaemoglobin dissociation curve in patients with severe coronavirus disease 2019 (COVID‐19)

Vogel, Dominik J; Formenti, Federico; Retter, Andrew; Vasques, Francesco; Camporota, Luigi

doi:10.1111/bjh.17128

Cited by 42 publications

(69 citation statements)

References 21 publications

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“…The lack of difference in measured P50 between COVID‐19 and healthy individuals contrasts with a recent study where P50 was calculated from blood gas analyzer 14 . Our results suggest that SARS‐CoV‐2 does not affect Hb oxygen affinity directly, but COVID‐19 patients may have increased Hb oxygen affinity due to hypoxia/metabolic adaptations 14 …”

Section: Discussioncontrasting

confidence: 93%

Impact of COVID‐19 on red blood cell rheology

et al. 2021

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Section: Discussioncontrasting

confidence: 93%

Impact of COVID‐19 on red blood cell rheology

et al. 2021

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“…The reasons why P 50 values were higher than the normal theoretical value were not discussed. In another British study, mean P 50 of 43 intubated and ventilated COVID-19 patients, retrospectively calculated from blood gas analyzer results, was 23.4 ± 3.13 mmHg, even significantly lower than a historical cohort of unmatched critically ill controls (24.6 ± 5.42 mmHg) (Vogel et al, 2020). The authors hypothesized that those low values could be explained by reduced [2,, and that for some reason it was even more reduced in COVID-19 patients.…”

Section: Discussionmentioning

confidence: 84%

The Affinity of Hemoglobin for Oxygen Is Not Altered During COVID-19

et al. 2021

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Background: A computational proteomic analysis suggested that SARS-CoV-2 might bind to hemoglobin (Hb). The authors hypothesized that this phenomenon could result in a decreased oxygen (O2) binding and lead to hemolytic anemia as well. The aim of this work was to investigate whether the affinity of Hb for O2 was altered during COVID-19.Methods: In this retrospective, observational, single-center study, the blood gas analyses of 100 COVID-19 patients were compared to those of 100 non-COVID-19 patients. Fifty-five patients with carboxyhemoglobin (HbCO) ≥8% and 30 with sickle cell disease (SCD) were also included (“positive controls” with abnormal Hb affinity). P50 was corrected for body temperature, pH, and PCO2.Results: Patients did not differ statistically for age or sex ratio in COVID-19 and non-COVID-19 groups. Median P50 at baseline was 26 mmHg [25.2–26.8] vs. 25.9 mmHg [24–27.3], respectively (p = 0.42). As expected, P50 was 22.5 mmHg [21.6–23.8] in the high HbCO group and 29.3 mmHg [27–31.5] in the SCD group (p < 0.0001). Whatever the disease severity, samples from COVID-19 to non-COVID-19 groups were distributed on the standard O2-Hb dissociation curve. When considering the time-course of P50 between days 1 and 18 in both groups, no significant difference was observed. Median Hb concentration at baseline was 14 g.dl–1 [12.6–15.2] in the COVID-19 group vs. 13.2 g.dl–1 [11.4–14.7] in the non-COVID-19 group (p = 0.006). Among the 24 COVID-19 patients displaying anemia, none of them exhibited obvious biological hemolysis.Conclusion: There was no biological argument to support the hypothesis that SARS-CoV-2 could alter O2 binding to Hb.

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“…published preliminary findings which suggest that the ODC actually shifts to the left in patients with COVID-19, despite the presence of a low arterial pH, perhaps because the prolonged periods of hypoxia associated with COVID-19 may allow patients to acclimatize to the hypoxia. 16 This publication, however, was contradicted by another which claims there to be no alteration in hemoglobin’s affinity for oxygen in patients with COVID-19 compared to a control, although this small sample size was not limited to mechanically ventilated patients in an ICU. 3 Thus oxygen affinity may be dynamic as the disease progresses.…”

Section: Discussionmentioning

confidence: 99%