A study showed that in a study of hospitalized COVID-19 patients, blood oxygen levels below 92% and rapid, shallow breathing are associated with a significant increase in mortality, which suggests that people who test positive for the virus should be at home Note that these signs are led by researchers at the University of Washington in Seattle.
The study, published today in Influenza and Other Respiratory Viruses, performed a chart review of 1,095 adult coronavirus patients who were hospitalized at Washington University Hospital or Chicago Rush University Medical Center from March 1 to June 8, 2020 .
Almost all patients with low oxygen levels (99%) and shortness of breath (98%) were given supplemental oxygen and corticosteroids to calm inflammation.
Of the 1,095 patients, 197 (18%) died in the hospital. Compared with hospitalized patients with normal blood oxygen saturation, patients with low blood oxygen saturation are 1.8 to 4.0 times more likely to die in the hospital. Similarly, patients with high respiratory rates are 1.9 to 3.2 times more likely to die than patients with normal respiratory rates.
Few patients report shortness of breath (10%) or cough (25%), even if their blood oxygen level is 91% or lower, or they breathe 23 times per minute or more. “In our study, only 10% of hospitalized patients reported shortness of breath. The respiratory symptoms on admission were not related to hypoxemia [hypoxia] or mortality. This emphasizes that respiratory symptoms are not common and may not be Accurately identify high-risk patients,” the author wrote, adding that delayed identification may lead to poor results.
A higher body mass index is related to lower oxygen levels and faster breathing rates. Body temperature, heart rate and blood pressure have nothing to do with death.
The most common symptom on admission was fever (73%). The average age of the patients was 58 years, 62% were men, and many had underlying diseases such as hypertension (54%), diabetes (33%), coronary artery disease (12%) and heart failure (12%).
“These findings apply to the life experiences of most COVID-19 patients: being at home, feeling anxious, wondering how to know if their condition will progress, and wondering when it makes sense to go to the hospital,” co-lead author Neal Chatterjee Medical The doctor said at a press conference at the University of Washington
The author said that the results of the study indicate that even high-risk people with asymptomatic COVID-19 testing positive and having poor outcomes due to advanced age or obesity should calculate their breaths per minute and obtain a pulse oximeter to measure them. The author of their blood oxygen concentration study said at home. They said that the pulse oximeter can be clipped to your fingertips and costs less than $20. But even without a pulse oximeter, rapid breathing rate can be a sign of respiratory distress.
“A simpler measure is breathing rate-how many times do you breathe in a minute,” co-lead author Nona Sotoodehnia, MD, MPH said in a press release. “If you are not paying attention to breathing, let a friend or family member monitor you for one minute. If you breathe 23 times per minute, you should contact your doctor.”
Sotoodehnia pointed out that glucocorticoids and supplemental oxygen can benefit COVID-19 patients. “We provide patients with supplemental oxygen to maintain blood oxygen saturation at 92% to 96%,” she said. “It is important to note that only patients who use supplemental oxygen can benefit from the life-saving effects of glucocorticoids.”
The researchers also called for revisions to the COVID-19 guidelines of the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), which advise patients with coronavirus to seek medical attention when they experience obvious symptoms such as “dyspnea” and “dyspnea.” Constant pain or pressure in the chest. ”
ÂThe patient may not experience these symptoms, even if the breathing rate is fast and the blood oxygen level has dropped to a dangerous level. The guidelines are particularly important for first-line clinical contacts (such as family doctors and telemedicine service providers).
Chatterjee said: “We recommend that the CDC and WHO consider reformulating their guidelines to take into account these asymptomatic people who are actually worthy of hospitalization and care.” “But people don’t know the guidance of the WHO and the Centers for Disease Control and Prevention. Policy; we got this guidance from our doctors and news reports.”
CIDRAP-Center for Infectious Disease Research and Policy, Office of the Vice President for Research, University of Minnesota, Minneapolis, Minnesota
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Post time: Jun-18-2021