COVID-19 pneumonia often has “distinctive features” unlike those of acute respiratory distress syndrome, and may require a different treatment protocol, according to critical care specialists.
In fact, only 20% to 30% of COVID-19 cases studied by the doctors showed ARDS-like signs. Instead, about half had severe hypoxemia (low blood oxygen levels) with near normal respiratory signs.
“This remarkable combination is almost never seen in severe ARDS,” said Luciano Gattinoni, M.D., from the Medical University of Göttingen, Germany.
In addition, these patients often present differently from one another. Some even have normal breathing, despite low blood oxygen measurements. “The same disease actually presents itself with impressive non-uniformity,” Gattinoni wrote in an editorial published last week in Intensive Care Medicine.
Gattinoni and colleagues have previously warned that intubation and ventilation may not be the right choice for some COVID-19 patients with severe illness, and may actually cause lung injury. In the new editorial, they present alternative treatment possibilities that take the disease’s distinctive presentations into account.
In other coronavirus news:
Neuropsychiatric problems may appear months after COVID-19 recovery: Neuropsychiatric challenges may emerge in the weeks and months following recovery from COVID-19 infections, according to researchers at University of California San Diego School of Medicine. Based on data from past pandemics, the aftermath of severe viral illness may result in diverse symptoms. These include encephalopathy (altered brain function), mood changes, psychosis, neuromuscular dysfunction or demyelinating disorders, they write in the journal Brain, Behavior, and Immunity.
New data show GI symptoms in a third of COVID-19 patients: Data from the early days of the coronavirus outbreak in California show that gastrointestinal symptoms affected a third of patients. In addition to upper respiratory signs, a significant number had appetite loss, nausea, vomiting and diarrhea, write Stanford University researchers in Gastroenterology. “It’s possible we may be missing a significant portion of patients sick with the coronavirus due to our current testing strategies focusing on respiratory symptoms alone,” they conclude.
