Conceptions of the pathophysiology of happy hypoxemia in COVID-19

Dhont, Sebastiaan; Derom, Eric; Braeckel, Eva Van; Depuydt, Pieter; Lambrecht, Bart N.

doi:10.1186/s12931-021-01614-1

Cited by 31 publications

(30 citation statements)

References 30 publications

(36 reference statements)

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“… 38 The pathophysiological cause of silent hypoxaemia is unclear, but it may be due to intrapulmonary shunting, loss of lung perfusion regulation, endothelial injury and impaired diffusion capacity. 39 , 40 These patients require close monitoring. Desaturation may be transient but is often prolonged or associated with rapid respiratory decompensation.…”

Section: Methodsmentioning

confidence: 99%

Physiotherapy management for COVID-19 in the acute hospital setting and beyond: an update to clinical practice recommendations

Thomas

Baldwin

Beach

et al. 2022

Journal of Physiotherapy

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This document provides an update to the recommendations for physiotherapy management for adults with coronavirus disease 2019 (COVID-19) in the acute hospital setting. It includes: physiotherapy workforce planning and preparation; a screening tool for determining requirement for physiotherapy; and recommendations for the use of physiotherapy treatments and personal protective equipment. New advice and recommendations are provided on: workload management; staff health, including vaccination; providing clinical education; personal protective equipment; interventions, including awake proning, mobilisation and rehabilitation in patients with hypoxaemia. Additionally, recommendations for recovery after COVID-19 have been added, including roles that physiotherapy can offer in the management of post-COVID syndrome. The updated guidelines are intended for use by physiotherapists and other relevant stakeholders caring for adult patients with confirmed or suspected COVID-19 in the acute care setting and beyond.

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Section: Methodsmentioning

confidence: 99%

Physiotherapy management for COVID-19 in the acute hospital setting and beyond: an update to clinical practice recommendations

Thomas

Baldwin

Beach

et al. 2022

Journal of Physiotherapy

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show abstract

“…That means damaged alveolar epithelial cells and the pulmonary endothelial cell can activate platelets and induce intravascular microthrombi formation [58] , [71] . The above changes appear to contribute to impaired hypoxemic vasoconstriction and the clinical phenotype of happy hypoxemia [72] . SARS-CoV-2 infection-specific inflammatory cytokine and growth factor dysregulation SARS-CoV-2 induces the production and release of inflammatory mediators including cytokines and chemokines.…”

Section: Sars-cov-2 Induced Inflammation and Coagulopathymentioning

confidence: 99%

Section: Sars-cov-2 Induced Inflammation and Coagulopathymentioning

confidence: 99%

Role of SARS-CoV-2 -induced cytokines and growth factors in coagulopathy and thromboembolism

Ahmad

Kannan

Ansari

2022

Cytokine & Growth Factor Reviews

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Severe COVID-19 patients frequently present thrombotic complications which commonly lead to multiorgan failure and increase the risk of death. Severe SARS-CoV-2 infection induces the cytokine storm and is often associated with coagulation dysfunction. D-dimer, a hallmark of venous thromboembolism (VTE), is observed at a higher level in the majority of hospitalized COVID-19 patients. The precise molecular mechanism of the disproportionate effect of SARS-CoV-2 infection on the coagulation system is largely undefined. SARS-CoV-2 –induced endotheliopathy and, induction of cytokines and growth factors (GFs) most likely play important roles in platelet activation, coagulopathy, and VTE. Generally, viral infections lead to systemic inflammation and induction of numerous cytokines and GFs and many of them are reported to be associated with increased VTE. Most importantly, platelets play key thromboinflammatory roles linking coagulation to immune mediators in a variety of infections including response to viral infection. Since the pathomechanism of coagulopathy and VTE in COVID-19 is largely undefined, herein we highlight the association of dysregulated inflammatory cytokines and GFs with thrombotic complications and coagulopathy in COVID-19.

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“…Damaged respiratory epithelial cells and pulmonary endothelial dysfunction activate platelets and formation of intravascular microthrombi ( Connors and Levy, 2020 ; Del Turco et al, 2020 ). These pathophysiological changes will contribute to impaired hypoxemic vasoconstriction and the clinical phenotype of “happy hypoxemia” in COVID-19 patients ( Dhont et al, 2021 ). If the immune system doesn’t gain control, endothelial dysfunction and coagulation defects might spread systemically causing vasculitis, disseminated intravascular coagulopathy (DIC) and immunothrombosis ( Engelmann and Massberg, 2013 ; Jackson et al, 2019 ).…”

Section: Respiratory Immunologymentioning

confidence: 99%

How and to What Extent Immunological Responses to SARS-CoV-2 Shape Pulmonary Function in COVID-19 Patients

2021

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COVID-19 is a disease caused by a new coronavirus SARS-CoV-2, primarily impacting the respiratory system. COVID-19 can result in mild illness or serious disease leading to critical illness and requires admission to ICU due to respiratory failure. There is intense discussion around potential factors predisposing to and protecting from COVID-19. The immune response and the abnormal respiratory function with a focus on respiratory function testing in COVID-19 patients will be at the center of this Perspective article of the Frontiers in Physiology Series on “The Tribute of Physiology for the Understanding of COVID-19 Disease.” We will discuss current advances and provide future directions and present also our perspective in this field.

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Conceptions of the pathophysiology of happy hypoxemia in COVID-19

Cited by 31 publications

References 30 publications

Physiotherapy management for COVID-19 in the acute hospital setting and beyond: an update to clinical practice recommendations

Physiotherapy management for COVID-19 in the acute hospital setting and beyond: an update to clinical practice recommendations

Role of SARS-CoV-2 -induced cytokines and growth factors in coagulopathy and thromboembolism

How and to What Extent Immunological Responses to SARS-CoV-2 Shape Pulmonary Function in COVID-19 Patients

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