Covid Hypoxemia Different From ARDs

A team of doctors at Mount Sinai Hospital in New York published a letter in the American Journal of Respiratory & Critical Care Medicine on August 6, 2020, which says 'some patients with COVID-19 pneumonia demonstrate severe hypoxemia despite having near-normal lung compliance, a combination not commonly seen in typical acute respiratory distress syndrome (ARDS).

The disconnect between gas exchange and lung mechanics in COVID-19 pneumonia has raised the question of whether the mechanisms of hypoxemia in COVID-19 pneumonia differ from those in classical ARDS. Their new research found dual-energy CT imaging demonstrated pulmonary vessel dilatation and autopsies have shown pulmonary capillary deformation in patients with COVID-19 pneumonia.

This new finding supports a previous study published on April 14, 2020, that said 'Type L and Type H patients are best identified by CT scan and are affected by different pathophysiological mechanisms. "This combination is almost never seen in ARDS," Luciano Gattinoni, M.D., of the University of Gottingen, wrote in an editorial in Intensive Care Medicine.

And, 'understanding the correct pathophysiology is crucial to establishing the basis for appropriate COVID-19 treatment.'