Studies show that abnormal blood oxygen levels and respiratory rate are strong predictors of poor patient outcomes in the hospital-ScienceDaily.

This context directs people with COVID-19 to see a doctor when they experience overt symptoms such as “dyspnea” or “persistent chest pain or pressure” at the US Centers for Disease Control and Prevention. Lacking current guidance from. The author says there are signs that may not be present even when breathing and blood oxygen reach dangerous levels.

“These findings apply to the living experience of the majority of COVID-19 patients. They are at home, feel anxious, want to know how to know if their illness progresses, and when it makes sense to go to the hospital. I wonder if this is the case, “he said. Neil Chatterjee, University of Washington School of Medicine.

Chatterjee and cardiologist Dr. Nona Sotoodehnia were co-authors of a treatise scheduled to be published in the journal on May 24th. Influenza and other respiratory viruses..

The findings suggest that some people with COVID-19 may have passed the window of early medical intervention by the time they felt sick enough to come to the hospital. Stated.

“Initially, most patients with COVID do not have dyspnea. Even very low oxygen saturation can be asymptomatic,” says Sotoodehnia. “If patients follow current guidance, they may not be short of breath until their blood oxygen is significantly low, so they miss the opportunity to intervene early in life-saving treatment.”

The researchers investigated cases of 1,095 patients aged 18 years and older who were admitted to the UW Medical Hospital in Seattle or the Rush University Medical Center in Chicago with COVID-19. The survey period was from March 1st to June 8th, 2020. The only exclusion was those who chose “comfort only” at the time of admission.

Patients frequently experienced hypoxemia (low blood oxygen saturation; less than 91% in this study) or tachypnea (fast and shallow breathing; 23 breaths per minute in this study), but in the blood Few people reported shortness of breath or coughing regardless of oxygen.

The primary measure of this study was in-hospital mortality from all causes. Overall, 197 patients died in the hospital. Compared to patients hospitalized with normal blood oxygen, patients with hypoxemia were 1.8 to 4.0 times more likely to die, depending on their blood oxygen levels. Similarly, patients with tachypnea had a 1.9 to 3.2 times higher risk of death than those hospitalized with normal respiratory rates. In contrast, other clinical signs on admission, such as body temperature, heart rate, and blood pressure, were not associated with mortality.

Almost all patients with hypoxemia and tachypnea required oxygen supplementation that could effectively treat acute cases of COVID-19 when combined with glucocorticoids, which reduce inflammation.

“We give patients oxygenation to maintain 92% to 96% blood oxygen saturation. Only patients receiving oxygenation benefit from the life-saving effect of glucocorticoids. It’s important to note that, “said Sotoodehnia. “Our hypoxemic patients had an average of 91% oxygen saturation on admission, far below where so many patients had already taken life-saving measures. For, that care was delayed. “

The findings are usually relevant to family care workers and virtual care providers who are the front-line clinical contacts of people who have a positive COVID-19 test and want to monitor meaningful symptoms.

“With CDC [World Health Organization] Consider recreating guidelines to explain this population of asymptomatic people who really deserve hospitalization and care, “Chatterjee said. This guidance comes from doctors and news articles. “

Sotoodehnia says that people who test positive for COVID-19, especially those at high risk of adverse consequences from old age or obesity, should buy or rent a pulse oximeter to monitor less than 92% of blood oxygen. Recommended. Devices like clips fit at your fingertips and can be purchased for less than $ 20.

“A simpler measure is your breathing rate. How many times you breathe per minute. Watch your friends or family for one minute while you’re not paying attention to your breathing and if you breathe 23 times a minute. Please ask, you should contact your doctor, “she said.