Doctors Puzzle Over COVID-19 Lung Problems

WebMD ^ | April 7, 2020 | Brenda Goodman, MA

[ConservativeMind]

As doctors treat more patients who are severely ill from COVID-19, they’re noticing differences in how their lungs are damaged.

Some patients coming to the hospital have very low oxygen levels in their blood, but you wouldn’t know it from talking to them. They don’t seem starved of oxygen. They may be a little confused. But they aren’t struggling to breathe.

When doctors take pictures of their lungs -- either with a CT scanner or an X-ray machine -- those also look fairly healthy.

One doctor treating COVID-19 patients in says it was like altitude sickness.

Luciano Gattinoni, MD, says more than half the patients he and his colleagues have treated in Northern Italy have had this unusual symptom. They seem to be able to breathe just fine, but their oxygen is very low.

According to Gattinoni, about 30% of COVID-19 patients who come to the hospital have more classic symptoms of ARDS.

Gattinoni says doctors need to pay attention to how COVID-19 has affected the lungs and breathing of each patient they’re treating before deciding on treatment. Patients with more classic ARDS-type COVID-19 often need mechanical ventilation right away, which forces air into the lungs to increase oxygen.

Patients with respiratory failure who can still breathe OK, but have still have very low oxygen, may improve on oxygen alone, or on oxygen delivered through a lower pressure setting on a ventilator.

He says these patients with more normal-looking lungs may also be especially vulnerable to ventilator-associated lung injury.

Gattinoni said one center in central Europe that had begun using different treatments for different types of COVID-19 patients had not seen any deaths in its intensive care unit. He said a nearby hospital that was treating all COVID-19 patients [without such customization] had a 60% death rate in its ICU.

[ConservativeMind]

Mortality rate of COVID-19 patients on ventilators:
https://www.physiciansweekly.com/mortality-rate-of-covid-19-patients-on-ventilators/

An interesting posting a FReeper provided yesterday that says something similar, but believes the low oxygen to be from lost red blood cells:
https://web.archive.org/web/20200405061401/https://medium.com/@agaiziunas/covid-19-had-us-all-fooled-but-now-we-might-have-finally-found-its-secret-91182386efcb