Oxyhemoglobin Dissociation Curve in COVID-19 Patients
Yıl: 2023 Cilt: 24 Sayı: 1 Sayfa Aralığı: 58 - 64 Metin Dili: İngilizce DOI: 10.4274/meandros.galenos.2023.87049 İndeks Tarihi: 01-06-2023
Oxyhemoglobin Dissociation Curve in COVID-19 Patients
Öz: Objective: Coronavirus disease-2019 (COVID-19) is a disease that can progress with hypoxemia and severe respiratory distress in some patients. The oxyhemoglobin dissociation curve (ODC) is critical to understanding the effects of O2 exchange. This study aimed to evaluate the relationship between the ODC and oxygen-carrying capacity of hemoglobin (Hb) in COVID-19 patients. Materials and Methods: In the study, ODCs were created by examining the data obtained from the arterial blood gas analyses of 686 intensive care unit (ICU) and non-ICU COVID-19 patients retrospectively. Results: It was concluded that patients with COVID-19 and other respiratory distress patients had a slight right-leaning trend in the ODC compared with the standard curve. The P50 value of the ICU group was higher than the other groups (mean: 30.74 mmHg, n=131, p=0.047). While the percentage of oxyhemoglobin (mean: 65.44% vs 69.81%, p=0.015), the amount of glucose (mean: 163.39 mg/dL vs 195.36 mg/dL, p=0.002) and pH (median: 7.38 vs 7.41, p=0.007) in the non-ICU group was higher compared with the control group, the carboxyhemoglobin percentage (mean: 1.66% vs 1.13%, p=0.000), PCO2 (42.02 mmHg vs 39.44 mmHg, p=0.015), potassium (mean: 4.33 mmol/L vs 4.04, p=0.026), and sodium (mean: 138.10 mmol/L vs 135.80 mmol/L, p=0.000) were lower. The methemoglobin percentage of the ICU group was lower (p=0.000) than the other groups. Conclusion: The ODC of COVID-19 and other respiratory distress patients shifts slightly to the right, indicating that patients have partial respiratory difficulties.
Anahtar Kelime: COVID-19 Hastalarında Oksihemoglobin Disosiasyon Eğrisi
Öz: Amaç: Koronavirüs hastalığı-2019 (COVID-19), hipoksemi ve bazı hastalarda ciddi derecede solunum sıkıntısı ile seyredebilen bir hastalıktır. Oksihemoglobin disosiasyon eğrisi (ODC), O2 değişiminin etkilerini anlamak için çok önemlidir. Bu çalışmanın amacı; COVID-19 hastalarında ODC ve hemoglobin (Hb) arasındaki oksijen taşıma kapasitesi ilişkisini değerlendirmektir. Gereç ve Yöntemler: Çalışmada, yoğun bakım ünitesi (YBÜ) COVID-19, yoğun bakım dışı (non-YBÜ) COVID-19 ve COVID-19 olmayan diğer solunum sıkıntılı toplam 686 hastanın arter kan gazından elde edilen veriler retrospektif olarak incelenerek oksihemoglobin eğrileri oluşturuldu. Bulgular: COVID-19 tanılı ve diğer solunum sıkıntılı hastaların ODC’lerinin standart eğriye göre hafif sağa eğilim gösterdiği belirlendi. YBÜ grubunun P50 değeri, diğer gruplara kıyasla daha yüksekti (ortalama: 30,74 mmHg, n=131, p=0,047). Kontrole kıyasla non- YBÜ grubunun; oksihemoglobin yüzdesi (ortalama: %65,44 vs %69,81, p=0,015), PO2’ı (46,98 mmHg vs 48,98 mmHg, p=0,001), glikoz miktarı (ortalama: 163,39 mg/dL vs 195,36 mg/dL, p=0,002) ve pH’sı (medyan: 7,38 vs 7,41, p=0,007) daha yüksek iken karboksihemoglobin yüzdesi (ortalama: %1,66 vs %1,13, p=0,000), PCO2’ı (42,02 mmHg vs 39,44 mmHg, p=0,015), potasyum (ortalama: 4,33 mmol/L vs 4,04, p=0,026) ve sodyum (ortalama: 138,10 mmol/L vs 135,80 mmol/L, p=0,000) seviyesi daha düşüktü. YBÜ grubunun methemoglobin yüzdesi ise diğer gruplara kıyasla daha düşüktü (p=0,000). Sonuç: COVID-19 ve diğer solunum sıkıntılı hastaların ODC’si hafif sağa kaymaktadır, bu sonuç hastaların kısmen solunum güçlüğü çektiğini göstermektedir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med 2020; 382: 727-33.
- 2. Wu D, Wu T, Liu Q, Yang Z. The SARS-CoV-2 outbreak: What we know. Int J Infect Dis 2020; 94: 44-8.
- 3. Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020; 8: 475-81. Erratum in: Lancet Respir Med 2020; 8: e26.
- 4. Gattinoni L, Chiumello D, Caironi P, Busana M, Romitti F, Brazzi L, et al. COVID-19 pneumonia: different respiratory treatments for different phenotypes? Intensive Care Med 2020; 46: 1099-102.
- 5. Connors JM, Levy JH. Thromboinflammation and the hypercoagulability of COVID-19. J Thromb Haemost 2020; 18: 1559- 61.
- 6. Hall JE. Guyton and Hall Textbook of Medical Physiology (13th ed.). Philadelphia: Elsevier. 2016.
- 7. Srinivasan AJ, Morkane C, Martin DS, Welsby IJ. Should modulation of p50 be a therapeutic target in the critically ill? Expert Rev Hematol 2017; 10: 449-58.
- 8. Chu Z, Wang Y, You G, Wang Q, Ma N, Li B, et al. The P50 value detected by the oxygenation-dissociation analyser and blood gas analyser. Artif Cells Nanomed Biotechnol 2020; 48: 867-74.
- 9. Liu W, Li H. COVID-19: Attacks the 1-beta Chain of Hemoglobin and Captures the Porhyrin to Inhibit Heme Metabolism. Am Chem Soc 2020.
- 10. Cikman O, Ozkan A, Kiraz H, Karacaer M, Ocakli M, Hanci V, et al. A questionaire study evaluating the knowledge and approach by physicians about arterial blood gas. Clin Ter 2014; 165: e194-8.
- 11. Sadovsky R. Diabetic Ketoacidosis and Venous Blood Gas Values. American Family Physician 1998; 58.5: 1189.
- 12. Severinghaus JW. Simple, accurate equations for human blood O2 dissociation computations. J Appl Physiol Respir Environ Exerc Physiol 1979; 46: 599-602.
- 13. Imai K. Adair fitting to oxygen equilibrium curves of hemoglobin. Methods Enzymol 1994; 232: 559-76.
- 14. Scrima R, Fugetto S, Capitanio N, Gatti DL. Hemoglobin Non-equilibrium Oxygen Dissociation Curve. arXiv preprint arXiv:200100091 2019.
- 15. Daniel Y, Hunt BJ, Retter A, Henderson K, Wilson S, Sharpe CC, et al. Haemoglobin oxygen affinity in patients with severe COVID-19 infection. Br J Haematol 2020; 190: e126-7.
- 16. Vogel DJ, Formenti F, Retter AJ, Vasques F, Camporota L. A left shift in the oxyhaemoglobin dissociation curve in patients with severe coronavirus disease 2019 (COVID-19). Br J Haematol 2020; 191: 390-3.
- 17. MacIntyre NR. Tissue hypoxia: implications for the respiratory clinician. Respir Care 2014; 59: 1590-6.
- 18. Gunnerson KJ, Saul M, He S, Kellum JA. Lactate versus non-lactate metabolic acidosis: a retrospective outcome evaluation of critically ill patients. Crit Care 2006; 10: R22.
- 19. Snijder EJ, Decroly E, Ziebuhr J. The Nonstructural Proteins Directing Coronavirus RNA Synthesis and Processing. Adv Virus Res 2016; 96: 59-126.
- 20. Asher DR, Cerny AM, Finberg RW. The erythrocyte viral trap: transgenic expression of viral receptor on erythrocytes attenuates coxsackievirus B infection. Proc Natl Acad Sci U S A 2005; 102: 12897-902.
- 21. Fan BE. Hematologic parameters in patients with COVID-19 infection: a reply. Am J Hematol 2020; 95: E215.
- 22. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020; 382: 1708-20.
- 23. Mitra A, Dwyre DM, Schivo M, Thompson GR 3rd, Cohen SH, Ku N, et al. Leukoerythroblastic reaction in a patient with COVID-19 infection. Am J Hematol 2020; 95: 999-1000.
- 24. Nóbrega F, Mauad VAQ, Borducchi DMM. Does COVID-19 really impact on the oxy-hemoglobin dissociation curve? EJHaem 2020; 1: 604-7.
- 25. Bhatraju PK, Ghassemieh BJ, Nichols M, Kim R, Jerome KR, Nalla AK, et al. Covid-19 in Critically Ill Patients in the Seattle Region - Case Series. N Engl J Med 2020; 382: 2012-22.
| APA | Ustundag H, Mertoglu C, HUYUT M (2023). Oxyhemoglobin Dissociation Curve in COVID-19 Patients. , 58 - 64. 10.4274/meandros.galenos.2023.87049 |
| Chicago | Ustundag Hilal,Mertoglu Cuma,HUYUT Mehmet Tahir Oxyhemoglobin Dissociation Curve in COVID-19 Patients. (2023): 58 - 64. 10.4274/meandros.galenos.2023.87049 |
| MLA | Ustundag Hilal,Mertoglu Cuma,HUYUT Mehmet Tahir Oxyhemoglobin Dissociation Curve in COVID-19 Patients. , 2023, ss.58 - 64. 10.4274/meandros.galenos.2023.87049 |
| AMA | Ustundag H,Mertoglu C,HUYUT M Oxyhemoglobin Dissociation Curve in COVID-19 Patients. . 2023; 58 - 64. 10.4274/meandros.galenos.2023.87049 |
| Vancouver | Ustundag H,Mertoglu C,HUYUT M Oxyhemoglobin Dissociation Curve in COVID-19 Patients. . 2023; 58 - 64. 10.4274/meandros.galenos.2023.87049 |
| IEEE | Ustundag H,Mertoglu C,HUYUT M "Oxyhemoglobin Dissociation Curve in COVID-19 Patients." , ss.58 - 64, 2023. 10.4274/meandros.galenos.2023.87049 |
| ISNAD | Ustundag, Hilal vd. "Oxyhemoglobin Dissociation Curve in COVID-19 Patients". (2023), 58-64. https://doi.org/10.4274/meandros.galenos.2023.87049 |
| APA | Ustundag H, Mertoglu C, HUYUT M (2023). Oxyhemoglobin Dissociation Curve in COVID-19 Patients. Meandros Medical And Dental Journal, 24(1), 58 - 64. 10.4274/meandros.galenos.2023.87049 |
| Chicago | Ustundag Hilal,Mertoglu Cuma,HUYUT Mehmet Tahir Oxyhemoglobin Dissociation Curve in COVID-19 Patients. Meandros Medical And Dental Journal 24, no.1 (2023): 58 - 64. 10.4274/meandros.galenos.2023.87049 |
| MLA | Ustundag Hilal,Mertoglu Cuma,HUYUT Mehmet Tahir Oxyhemoglobin Dissociation Curve in COVID-19 Patients. Meandros Medical And Dental Journal, vol.24, no.1, 2023, ss.58 - 64. 10.4274/meandros.galenos.2023.87049 |
| AMA | Ustundag H,Mertoglu C,HUYUT M Oxyhemoglobin Dissociation Curve in COVID-19 Patients. Meandros Medical And Dental Journal. 2023; 24(1): 58 - 64. 10.4274/meandros.galenos.2023.87049 |
| Vancouver | Ustundag H,Mertoglu C,HUYUT M Oxyhemoglobin Dissociation Curve in COVID-19 Patients. Meandros Medical And Dental Journal. 2023; 24(1): 58 - 64. 10.4274/meandros.galenos.2023.87049 |
| IEEE | Ustundag H,Mertoglu C,HUYUT M "Oxyhemoglobin Dissociation Curve in COVID-19 Patients." Meandros Medical And Dental Journal, 24, ss.58 - 64, 2023. 10.4274/meandros.galenos.2023.87049 |
| ISNAD | Ustundag, Hilal vd. "Oxyhemoglobin Dissociation Curve in COVID-19 Patients". Meandros Medical And Dental Journal 24/1 (2023), 58-64. https://doi.org/10.4274/meandros.galenos.2023.87049 |
