Overlooking Obesity Hypoventilation Syndrome: The Need for Obesity Hypoventilation Syndrome Staging and Risk Stratification

Randerath, Winfried; BaHammam, Ahmed S.

doi:10.1513/annalsats.202006-683ed

Cited by 4 publications

(2 citation statements)

References 16 publications

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“…Obesity, a risk factor for disease severity in COVID-19, has an adverse effect on respiratory physiology is frequently associated with sleep apnea ( Kimura T. et al, 2020 ). Also, a significant fraction of obese patients suffer from obesity hypoventilation syndrome ( Randerath W.J. et al 2020 ).…”

Section: Major Determinants Of Mortality In Sars-cov-2 Are Related To Early Hypoxiamentioning

confidence: 99%

Hypoxia may be a determinative factor in COVID-19 progression

Grieb¹,

Świątkiewicz²,

Prus³

et al. 2021

Current Research in Pharmacology and Drug Discovery

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The disease which develops following SARS-CoV-2 virus infection, known as COVID-19, in most affected countries displays mortality from 1.5% to 9.8%. When leukocytosis due to granulocytosis, thrombocytopenia, and increased level of D-dimers are detected early during the disease course, they are accurate predictors of mortality. Based on the published observations that each of the aforementioned disturbances by itself may appear as a consequence of hypoxia, a hypothesis is presented that early hypoxia consequential to sleep apnea and/or blunted respiratory response to chemical stimuli is an early determinant of COVID-19 progression to the severe and critical stage. Further, it is noted that host-directed therapies which may counteract hypoxia and its early downstream effects are initiated only upon hospitalization of COVID-19 patients, which is too late to be fully effective. An example is anticoagulation treatment with low molecular weight heparin. Repurposing drugs which could counteract some early posthypoxic events, such as fluvoxamine, amantadine and N-acetylcysteine, for post-exposure prophylaxis of SARS-CoV-2 infection and early prehospital treatment of COVID-19, is indicated.

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Section: Major Determinants Of Mortality In Sars-cov-2 Are Related To Early Hypoxiamentioning

confidence: 99%

Hypoxia may be a determinative factor in COVID-19 progression

Grieb¹,

Świątkiewicz²,

Prus³

et al. 2021

Current Research in Pharmacology and Drug Discovery

View full text Add to dashboard Cite

show abstract

“…It is believed that isolated sleep hypoventilation (defined as a transcutaneous carbon dioxide pressure, PtcCO2 >55 mmHg or >50 mmHg if PtcCO2 increases by more than 10 mmHg for more than 10 minutes of sleep compared to awake supine value) without awake hypercapnia precedes OHS, similarly to what is observed in neuromuscular and chest wall diseases [5,6]. This condition is called obesity-related sleep hypoventilation (ORSH) and it is now considered as an early stage of hypoventilation in patients with obesity [7,8]. Recent evidence has shown that 19% of patients with grade III obesity undergoing polysomnography with PtcCO2 monitoring for suspected sleep-disordered breathing present ORSH [9], thus supporting the effectiveness of such combined diagnostic approach during sleep to correctly identify sleep-disordered breathing in this population.…”

Section: Introductionmentioning

confidence: 99%