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

• DOI: 10.1111/bjh.17128
• Publication Date: 2020-10-10T07:54:44Z
• Authors: Dominik J. Vogel; Federico Formenti; Andrew J. Retter; Francesco Vasques; Luigi Camporota
• Keywords: Adult; Male; Partial Pressure; Pneumonia, Viral; Betacoronavirus; 03 medical and health sciences; 0302 clinical medicine; Humans; Hypoxia; Pandemics; Aged; Retrospective Studies; Models, Cardiovascular; COVID-19; Hematology; Carbon Dioxide; Hydrogen-Ion Concentration; Middle Aged; 3. Good health; Oxygen; Dyspnea; Oxyhemoglobins; Female; Coronavirus Infections

AbstractCritically 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–O2) affinity. Calculated oxygen tension at half‐saturation (p50) was on average (±SD) 3·3 (3·13) mmHg lower than the normal p50 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–O2 affinity (mean [SD] p50 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.