Pathophysiology of Hypoxemia in COVID-19 Lung Disease

Kai E Swenson; Charles C Hardin

doi:10.1016/j.ccm.2022.11.007

Pathophysiology of Hypoxemia in COVID-19 Lung Disease

Clin Chest Med. 2023 Jun;44(2):239-248. doi: 10.1016/j.ccm.2022.11.007. Epub 2022 Nov 23.

Authors

Kai E Swenson¹, Charles C Hardin²

Affiliations

¹ Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Bulfinch 148, 55 Fruit Street, Boston, MA 02114, USA. Electronic address: keswenson@mgh.harvard.edu.
² Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Bulfinch 148, 55 Fruit Street, Boston, MA 02114, USA.

Abstract

As the pandemic has progressed, our understanding of hypoxemia in coronavirus disease 2019 (COVID-19) lung disease has become more nuanced, although much remains to be understood. In this article, we review ventilation-perfusion mismatching in COVID-19 and the evidence to support various biologic theories offered in explanation. In addition, the relationship between hypoxemia and other features of severe COVID-19 lung disease such as respiratory symptoms, radiographic abnormalities, and pulmonary mechanics is explored. Recognizing and understanding hypoxemia in COVID-19 lung disease remains essential for risk stratification, prognostication, and choice of appropriate treatments in severe COVID-19.

Keywords: ARDS; COVID-19; Hypoxemia; SARS-CoV-2.

Publication types

Review

MeSH terms

COVID-19* / complications
Humans
Hypoxia / etiology
Hypoxia / therapy
Lung / diagnostic imaging
Lung Diseases*
SARS-CoV-2