Asymptomatic hypoxia in COVID-19 is associated with poor outcome

Brouqui, Philippe; Amrane, Sophie; Million, Matthieu; Cortaredona, Sébastien; Parola, Philippe; Lagier, Jean-Christophe; Raoult, Didier

Objectives Describe and evaluate the outcome of COVID patient without shortness of breath Design and methods We retrospectively collected data from COVID-19 patients diagnosed and cared for in Marseille France. We selected data from patients who had at admission, a low dose CT scanner, dyspnea status and oxygen saturation available. Blood-gas was analyzed in a sample subset of patients. Results Among 1712 patients with COVID-19 we report that 1107 (64.7%) do not complaint of a shortness of breath at admission. The LDCT scan showed signs compatible with pneumonia in 757/1,107 (68.4%) of patients without dyspnea. In a subset of patients who had underwent at least one blood gas analysis (n = 161) and presented without dyspnea at admission, 28.1% (27/96) presented with a hypoxemia/hypocapnia syndrome. Asymptomatic hypoxia was associated with a very poor outcome (33.3% were transferred to ICU and 25.9% died) Conclusion The absence of shortness of breath in old patient with co-morbidity merit medical attention and should not be considered as a good sign of wellbeing. The poor prognosis of asymptomatic hypoxia, highlight the severity of this mild clinical presentation. In these patient’s pulse oximetry is an important mean to predict the outcome along with news score and LDCT scanner.