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

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

doi:10.1111/bjh.17128

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

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

Centre for Human & Applied Physiological Sciences

Research output: Contribution to journal › Article › peer-review

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Abstract

Critically ill patients with coronavirus disease 2019 (COVID-19) present with hypoxaemia and are mechanically ventilated to support gas exchange. We performed a retrospective, observational study of blood gas analyses (n = 3518) obtained from patients with COVID-19 to investigate changes in haemoglobin oxygen (Hb–O ₂) affinity. Calculated oxygen tension at half-saturation (p ₅₀) was on average (±SD) 3·3 (3·13) mmHg lower than the normal p ₅₀ value (23·4 vs. 26·7 mmHg; P < 0·0001). Compared to an unmatched historic control of patients with other causes of severe respiratory failure, patients with COVID-19 had a significantly higher Hb–O ₂ affinity (mean [SD] p ₅₀ 23·4 [3·13] vs. 24·6 [5.4] mmHg; P < 0·0001). We hypothesise that, due to the long disease process, acclimatisation to hypoxaemia could play a role.

Original language	English
Pages (from-to)	390-393
Number of pages	4
Journal	British Journal of Haematology
Volume	191
Issue number	3
DOIs	https://doi.org/10.1111/bjh.17128
Publication status	Published - 1 Nov 2020

Keywords

Haematology
Physiology
oxygen affinity
COVID-19
Intensive care medicine

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VogelDJ ODC_LeftShiftCOVID AcceptedMsAccepted author manuscript, 1.31 MB

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title = "A left shift in the oxyhaemoglobin dissociation curve in patients with severe coronavirus disease 2019 (COVID-19)",

abstract = "Critically ill patients with coronavirus disease 2019 (COVID-19) present with hypoxaemia and are mechanically ventilated to support gas exchange. We performed a retrospective, observational study of blood gas analyses (n = 3518) obtained from patients with COVID-19 to investigate changes in haemoglobin oxygen (Hb–O 2) affinity. Calculated oxygen tension at half-saturation (p 50) was on average (±SD) 3·3 (3·13) mmHg lower than the normal p 50 value (23·4 vs. 26·7 mmHg; P < 0·0001). Compared to an unmatched historic control of patients with other causes of severe respiratory failure, patients with COVID-19 had a significantly higher Hb–O 2 affinity (mean [SD] p 50 23·4 [3·13] vs. 24·6 [5.4] mmHg; P < 0·0001). We hypothesise that, due to the long disease process, acclimatisation to hypoxaemia could play a role. ",

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author = "Vogel, {Dominik J} and Federico Formenti and Andrew Retter and Francesco Vasques and Luigi Camporota",

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AU - Vogel, Dominik J

AU - Formenti, Federico

AU - Retter, Andrew

AU - Vasques, Francesco

AU - Camporota, Luigi

PY - 2020/11/1

Y1 - 2020/11/1

N2 - Critically ill patients with coronavirus disease 2019 (COVID-19) present with hypoxaemia and are mechanically ventilated to support gas exchange. We performed a retrospective, observational study of blood gas analyses (n = 3518) obtained from patients with COVID-19 to investigate changes in haemoglobin oxygen (Hb–O 2) affinity. Calculated oxygen tension at half-saturation (p 50) was on average (±SD) 3·3 (3·13) mmHg lower than the normal p 50 value (23·4 vs. 26·7 mmHg; P < 0·0001). Compared to an unmatched historic control of patients with other causes of severe respiratory failure, patients with COVID-19 had a significantly higher Hb–O 2 affinity (mean [SD] p 50 23·4 [3·13] vs. 24·6 [5.4] mmHg; P < 0·0001). We hypothesise that, due to the long disease process, acclimatisation to hypoxaemia could play a role.

AB - Critically ill patients with coronavirus disease 2019 (COVID-19) present with hypoxaemia and are mechanically ventilated to support gas exchange. We performed a retrospective, observational study of blood gas analyses (n = 3518) obtained from patients with COVID-19 to investigate changes in haemoglobin oxygen (Hb–O 2) affinity. Calculated oxygen tension at half-saturation (p 50) was on average (±SD) 3·3 (3·13) mmHg lower than the normal p 50 value (23·4 vs. 26·7 mmHg; P < 0·0001). Compared to an unmatched historic control of patients with other causes of severe respiratory failure, patients with COVID-19 had a significantly higher Hb–O 2 affinity (mean [SD] p 50 23·4 [3·13] vs. 24·6 [5.4] mmHg; P < 0·0001). We hypothesise that, due to the long disease process, acclimatisation to hypoxaemia could play a role.

KW - Haematology

KW - Physiology

KW - oxygen affinity

KW - COVID-19

KW - Intensive care medicine

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

Abstract

Keywords

UN SDGs

Access to Document

Other files and links

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Mechanical ventilation in COVID-19: a physiological perspective

Pathophysiology of COVID-19 acute lung injury

The increased hemoglobin oxygen affinity in COVID-19

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