COVID-19-associated hypoxemia: Difference between revisions

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==Natural History, Complications, and Prognosis==
==Natural History, Complications, and Prognosis==


[[COVID-19]] has a range of clinical presentation, varying from asymptomatic to severe disease requiring ICU admission. Acute Respiratory Distress Syndrome (ARDS) (see [[COVID-19-associated acute respiratory distress syndrome]]) and [[pneumonia]], which are a common cause of [[hypoxemia]], can develop in 15% of patients.<ref name="pmid32195698">{{cite journal |vauthors=Greenland JR, Michelow MD, Wang L, London MJ |title=COVID-19 Infection: Implications for Perioperative and Critical Care Physicians |journal=Anesthesiology |volume=132 |issue=6 |pages=1346–1361 |date=June 2020 |pmid=32195698 |pmc=7155909 |doi=10.1097/ALN.0000000000003303 |url=}}</ref>
[[COVID-19]] has a range of clinical presentation, varying from asymptomatic to severe disease requiring ICU admission. Acute Respiratory Distress Syndrome (ARDS) (see [[COVID-19-associated acute respiratory distress syndrome]]) and [[pneumonia]], which are a common cause of [[hypoxemia]], can develop in 15% of patients.<ref name="pmid32195698">{{cite journal |vauthors=Greenland JR, Michelow MD, Wang L, London MJ |title=COVID-19 Infection: Implications for Perioperative and Critical Care Physicians |journal=Anesthesiology |volume=132 |issue=6 |pages=1346–1361 |date=June 2020 |pmid=32195698 |pmc=7155909 |doi=10.1097/ALN.0000000000003303 |url=}}</ref>

Revision as of 18:44, 5 July 2020

WikiDoc Resources for COVID-19-associated hypoxemia

Articles

Most recent articles on COVID-19-associated hypoxemia

Most cited articles on COVID-19-associated hypoxemia

Review articles on COVID-19-associated hypoxemia

Articles on COVID-19-associated hypoxemia in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on COVID-19-associated hypoxemia

Images of COVID-19-associated hypoxemia

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Evidence Based Medicine

Cochrane Collaboration on COVID-19-associated hypoxemia

Bandolier on COVID-19-associated hypoxemia

TRIP on COVID-19-associated hypoxemia

Clinical Trials

Ongoing Trials on COVID-19-associated hypoxemia at Clinical Trials.gov

Trial results on COVID-19-associated hypoxemia

Clinical Trials on COVID-19-associated hypoxemia at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on COVID-19-associated hypoxemia

NICE Guidance on COVID-19-associated hypoxemia

NHS PRODIGY Guidance

FDA on COVID-19-associated hypoxemia

CDC on COVID-19-associated hypoxemia

Books

Books on COVID-19-associated hypoxemia

News

COVID-19-associated hypoxemia in the news

Be alerted to news on COVID-19-associated hypoxemia

News trends on COVID-19-associated hypoxemia

Commentary

Blogs on COVID-19-associated hypoxemia

Definitions

Definitions of COVID-19-associated hypoxemia

Patient Resources / Community

Patient resources on COVID-19-associated hypoxemia

Discussion groups on COVID-19-associated hypoxemia

Patient Handouts on COVID-19-associated hypoxemia

Directions to Hospitals Treating COVID-19-associated hypoxemia

Risk calculators and risk factors for COVID-19-associated hypoxemia

Healthcare Provider Resources

Symptoms of COVID-19-associated hypoxemia

Causes & Risk Factors for COVID-19-associated hypoxemia

Diagnostic studies for COVID-19-associated hypoxemia

Treatment of COVID-19-associated hypoxemia

Continuing Medical Education (CME)

CME Programs on COVID-19-associated hypoxemia

International

COVID-19-associated hypoxemia en Espanol

COVID-19-associated hypoxemia en Francais

Business

COVID-19-associated hypoxemia in the Marketplace

Patents on COVID-19-associated hypoxemia

Experimental / Informatics

List of terms related to COVID-19-associated hypoxemia

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Synonyms and keywords:

Overview

Historical Perspective

  • In December 2019, novel coronavirus outbreak occurred in Wuhan, China[1]
  • On 11th March 2020 it was declared as Pandemic by WHO.

Classification

There is no established system for the classification of [disease name].

OR

[Disease name] may be classified according to [classification method] into [number] subtypes/groups: [group1], [group2], [group3], and [group4].

OR

[Disease name] may be classified into [large number > 6] subtypes based on [classification method 1], [classification method 2], and [classification method 3]. [Disease name] may be classified into several subtypes based on [classification method 1], [classification method 2], and [classification method 3].

OR

Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.

OR

If the staging system involves specific and characteristic findings and features: According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].

OR

The staging of [malignancy name] is based on the [staging system].

OR

There is no established system for the staging of [malignancy name].

Pathophysiology

The exact pathogenesis of [disease name] is not fully understood.

OR

It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].

OR

[Pathogen name] is usually transmitted via the [transmission route] route to the human host.

OR

Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.

OR


[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].

OR

The progression to [disease name] usually involves the [molecular pathway].

OR

The pathophysiology of [disease/malignancy] depends on the histological subtype.

Causes

  • Acute Respiratory Distress Syndrome
  • Microvascular Thrombi[2]
  • COVID-19 Pneumonia

Differentiating COVID-19-associated encephalopathy from other Diseases

[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].

OR

[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].

Epidemiology and Demographics

The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.

OR

In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.

OR

In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate of [number range]%.


Patients of all age groups may develop [disease name].

OR

The incidence of [disease name] increases with age; the median age at diagnosis is [#] years.

OR

[Disease name] commonly affects individuals younger than/older than [number of years] years of age.

OR

[Chronic disease name] is usually first diagnosed among [age group].

OR

[Acute disease name] commonly affects [age group].


There is no racial predilection to [disease name].

OR

[Disease name] usually affects individuals of the [race 1] race. [Race 2] individuals are less likely to develop [disease name].


[Disease name] affects men and women equally.

OR

[Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.


The majority of [disease name] cases are reported in [geographical region].

OR

[Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].

Risk Factors

According to a study conducted in Wuhan, China, the following risk factors were identified in patients presenting with hypoxemia (Spo2< 90%)[3]

  • Older age ( median - 60 years)
  • Male sex
  • Hypertension
  • Dyspnea on clinical presentation

Natural History, Complications, and Prognosis

COVID-19 has a range of clinical presentation, varying from asymptomatic to severe disease requiring ICU admission. Acute Respiratory Distress Syndrome (ARDS) (see COVID-19-associated acute respiratory distress syndrome) and pneumonia, which are a common cause of hypoxemia, can develop in 15% of patients.[4]


Common complications of hypoxemia include acute respiratory failure, (see COVID-19-associated respiratory failure) and multiorgan failure.


Prognosis is generally poor for patients presenting with hypoxemia. It has been identified as an independent risk factor for mortality due to COVID-19.[5][6]Patients who require mechanical ventilation have a mortality rate of 50%-60%.[5]

Diagnosis

Diagnostic Study of Choice

The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].

OR

The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].

OR

The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].

OR

There are no established criteria for the diagnosis of [disease name].

History and Symptoms

Dry cough is the most common symptom of COVID-19 infection. In patients presenting with hypoxemia the respiratory rate is high.

OR

The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].

Physical Examination

Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].

OR

Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

The presence of [finding(s)] on physical examination is diagnostic of [disease name].

OR

The presence of [finding(s)] on physical examination is highly suggestive of [disease name].

Laboratory Findings

An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].

OR

Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

OR

[Test] is usually normal among patients with [disease name].

OR

Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].

OR

There are no diagnostic laboratory findings associated with [disease name].

Electrocardiogram

There are no ECG findings associated with [disease name].

OR

An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

X-ray

There are no x-ray findings associated with [disease name].

OR

An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

Echocardiography or Ultrasound

There are no echocardiography/ultrasound findings associated with [disease name].

OR

Echocardiography/ultrasound may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no echocardiography/ultrasound findings associated with [disease name]. However, an echocardiography/ultrasound may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

CT scan

There are no CT scan findings associated with [disease name].

OR

[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

MRI

There are no MRI findings associated with [disease name].

OR

[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

Other Imaging Findings

There are no other imaging findings associated with [disease name].

OR

[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

Other Diagnostic Studies

There are no other diagnostic studies associated with [disease name].

OR

[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].

Treatment

Medical Therapy

There is no treatment for [disease name]; the mainstay of therapy is supportive care.

OR

Supportive therapy for [disease name] includes [therapy 1], [therapy 2], and [therapy 3].

OR

The majority of cases of [disease name] are self-limited and require only supportive care.

OR

[Disease name] is a medical emergency and requires prompt treatment.

OR

The mainstay of treatment for [disease name] is [therapy].

OR

The optimal therapy for [malignancy name] depends on the stage at diagnosis.

OR

[Therapy] is recommended among all patients who develop [disease name].

OR

Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].

OR

Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].

OR

Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].

OR

Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].

Surgery

Surgical intervention is not recommended for the management of [disease name].

OR

Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]

OR

The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].

OR

The feasibility of surgery depends on the stage of [malignancy] at diagnosis.

OR

Surgery is the mainstay of treatment for [disease or malignancy].

Primary Prevention

There are no established measures for the primary prevention of [disease name].

OR

There are no available vaccines against [disease name].

OR

Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].

OR

[Vaccine name] vaccine is recommended for [patient population] to prevent [disease name]. Other primary prevention strategies include [strategy 1], [strategy 2], and [strategy 3].

Secondary Prevention

There are no established measures for the secondary prevention of [disease name].

OR

Effective measures for the secondary prevention of [disease name] include [strategy 1], [strategy 2], and [strategy 3].

References

  1. Wu YC, Chen CS, Chan YJ (March 2020). "The outbreak of COVID-19: An overview". J Chin Med Assoc. 83 (3): 217–220. doi:10.1097/JCMA.0000000000000270. PMC 7153464 Check |pmc= value (help). PMID 32134861 Check |pmid= value (help).
  2. . doi:10.1016/ S1473-3099(20)30367-4 Check |doi= value (help). Missing or empty |title= (help)
  3. Xie, Jiang; Covassin, Naima; Fan, Zhengyang; Singh, Prachi; Gao, Wei; Li, Guangxi; Kara, Tomas; Somers, Virend K. (2020). "Association Between Hypoxemia and Mortality in Patients With COVID-19". Mayo Clinic Proceedings. 95 (6): 1138–1147. doi:10.1016/j.mayocp.2020.04.006. ISSN 0025-6196.
  4. Greenland JR, Michelow MD, Wang L, London MJ (June 2020). "COVID-19 Infection: Implications for Perioperative and Critical Care Physicians". Anesthesiology. 132 (6): 1346–1361. doi:10.1097/ALN.0000000000003303. PMC 7155909 Check |pmc= value (help). PMID 32195698 Check |pmid= value (help).
  5. 5.0 5.1 Pan F, Yang L, Li Y, Liang B, Li L, Ye T, Li L, Liu D, Gui S, Hu Y, Zheng C (2020). "Factors associated with death outcome in patients with severe coronavirus disease-19 (COVID-19): a case-control study". Int J Med Sci. 17 (9): 1281–1292. doi:10.7150/ijms.46614. PMC 7294915 Check |pmc= value (help). PMID 32547323 Check |pmid= value (help).
  6. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B (March 2020). "Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study". Lancet. 395 (10229): 1054–1062. doi:10.1016/S0140-6736(20)30566-3. PMC 7270627 Check |pmc= value (help). PMID 32171076 Check |pmid= value (help).


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