Approach to Respiratory System Involvement and the Symptom of Dyspnea in Covid-19 Disease

Gülsüm Hilal Demir; Burcu Kayhan Tetik

doi:10.19127/mbsjohs.959305

Review

Year 2021, Volume: 7 Issue: 3, 439 - 445, 31.12.2021

Gülsüm Hilal Demir Burcu Kayhan Tetik

https://doi.org/10.19127/mbsjohs.959305

Abstract

References

1. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020, World Health Organization (WHO), https://www.who.int/dg/ speeches/detail/ who-director-general-s-opening-remarks-atthe-media-briefing-on-covid-19-11-march2020, (erişimtarihi: 01.05.2021).
2. J.AndréKnottnerus, Betweeniatrotropic stimulus and interiatric referral: the domain of primary care research,Journal of Clinical Epidemiology,Volume 55, Issue 12,2002,Pages 1201-1206,ISSN 0895-4356
3. Coronaviridae Study Group of the International Committee on Taxonomy of Viruses, the species severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2, Nat Microbiol 2020 Apr;5(4):536-544. doi: 10.1038/s41564-020-0695-z. Epub 2020 Mar 2 4. McIntosh K, Dees JH, Becker WB, Kapikian AZ, Chanock RM. Recovery in tracheal organ cultures of novel viruses from patients with respiratory disease. Proc Natl Acad Sci USA 1967;57:933-40.
5. T.R. Ministry of Health, General Directorate of Public Health: COVID-19 (SARS-CoV-2 INFECTION) GUIDE. Scientific BoardStudy, T.C. Ministry of Health 12 April 2020, Ankara
6. Indwiani Astuti and Ysrafil, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): An overview of viral structure and host response, Diabetes MetabSyndr. 2020; 14(4): 407–12.
7. Li G, Fan Y, Lai Y, Han T, Li Z, Zhou P. Coronavirus infections and immune responses. J Med Virol. 2020;92:424–32
8. Jing Yang, Ya Zheng, Xi Gou, Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis, Int J Infect Dis. 2020;94:91-95
9. Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, Latin American Network of Coronavirus Disease 2019-COVID-19 Research (LANCOVID-19). Electronic address: https://www.lancovid.org. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis. 2020;34:101623. doi: 10.1016/j.tmaid.2020.101623. Epub 2020 Mar 13.
10. Wong HYF, Lam HYS, Fong AH, Leung ST, Chin TW, Lo CSY, et al.. Frequency and Distribution of Chest Radiographic Findings in Patients Positive for COVID-19. Radiology. 2020;296(2):E72-E78. doi: 10.1148/radiol.2020201160. Epub 2020 Mar 27
11. Bernheim A. Mei X. Huang M. Chest CT findings in coronavirus disease-19 (COVID-19): relationship to duration of infection. Radiology. 2020:200463
12. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. Jama. 2020;323(13):1239–1242.
13. Wang Y, Wang Y, Chen Y, Qin Q. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID‐19) implicate special control measures. J Med Virol. 2020;1–9: 10.1002/jmv.25748
14. Zhou M, Zhang X, Qu J. Coronavirus disease 2019 (COVID-19): a clinical update. (2020) Front Med. 2020; 2. doi: 10.1007/s11684- 020-0767-8.
15. Gattinoni L, Chiumello D, Rossi S. (2020). COVID-19 pneumonia: ARDS or not? Crit Care, 24(1): 154. doi:10.1186/s13054-020- 02880-z
16. Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, Liu S, Zhao P, Liu H, Zhu L, Tai Y, Bai C, Gao T, Song J, Xia P, Dong J, Zhao J, Wang FS. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8(4):420-422. doi: 10.1016/S2213-2600(20)30076-X.
17. Wong CK, Lam CWK, Wu AKL, Plasma inflammatorcytokines and chemokines in severeacute respiratory syndrome. Clin ExpImmun, 2004;136(1):95-103.4
18. Ministry of Health, COVID-19 Adult Treatment Algorithm. Access date: 9 May 2021. Available from: https://covid19.saglik.gov.tr
19. Braithwaite S, Perina D. Dyspnea. In: Marx CA, editor-in-chief. Rosen's emergency medicine: concepts and clinical practice,7th ed. Philadelphia: Mosby Incorporated; 2010.
20. American Thoracic Society. Dyspnea Mechanisms, assessment, and management: A consensus statement. Am J Respir Crit Care Med 1999;159:321-40
21. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8(4):420-22. doi: 10.1016/S2213-2600(20)30076-X.
22. Zheng Z, Peng F, Xu B, Zhao J, Liu H, Peng J, Li Q, Jiang C, Zhou Y, Liu S, Ye C, Zhang P, Xing Y, Guo H, Tang W. Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. J Infect. 2020 Aug;81(2):e16-e25. doi: 10.1016/j.jinf.2020.04.021. Epub 2020 Apr 23.
23. Xu L, Mao Y, Chen G. Risk factors for 2019 novel coronavirus disease (COVID-19) patients progressing to critical illness: a systematic review and meta-analysis. Aging (Albany NY). 2020;12(12):12410-12421. doi:10.18632/aging.103383
24. Xie J, Covassin N, Fan Z, Singh P, Gao W, Li G, et al. Association Between Hypoxemia and Mortality in Patients With COVID-19. Mayo Clin Proc. 2020;95(6):1138-47. doi: 10.1016/j.mayocp.2020.04.006. Epub 2020 Apr 11. 25. Jain V, Yuan JM. Predictive symptoms and comorbidities for severe COVID-19 and intensive care unit admission: a systematic review and meta-analysis. Int J Public Health. 2020;65(5):533-546. doi:10.1007/s00038-020-01390-7
26. Erbay A, Long COVID: A New Definition, Bozok Tıp Derg 2020;10(4):111-114
27. Carfì A, Bernabei R, Landi F; for the Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent Symptoms in Patients After Acute COVID-19. JAMA. 2020;324(6):603-605.
28. Lerum TV, Aaløkken TM, Brønstad E, Aarli B, Ikdahl E, Lund KMA, et.al. Dyspnoea, lung function and CT findings three months after hospital admission for COVID-19. Eur Respir J. 2020 Dec 10:2003448. doi: 10.1183/13993003.03448-2020. Epub ahead of print. PMID: 33303540; PMCID: PMC7736755
29. Tobin MJ, Laghi F, Jubran A. Why COVID-19 Silent Hypoxemia Is Baffling to Physicians. Am J Respir Crit Care Med. 2020 Aug 1;202(3):356-360. doi: 10.1164/rccm.202006-2157CP. 30. Brouqui P, Amrane S, Million M, Cortaredona S, Parola P, Lagier JC, et. al. Asymptomatic hypoxia in COVID-19 is associated with poor outcome. Int J Infect Dis. 2021;102:233-238. doi: 10.1016/j.ijid.2020.10.067.
31. Banzett RB, Similowski T, Brown R.Addressing respiratory discomfort in the ventilated patient Tobin MJ.editor. Principles and practice of mechanical ventilation 3rd ed New York: McGraw-Hill Inc.2012;1265–1280.
32. Tobin MJ, Laghi F, Jubran A. Why COVID-19 Silent Hypoxemia Is Baffling to Physicians. Am J Respir Crit Care Med. 2020;202(3):356-360. doi: 10.1164/rccm.202006-2157CP
33. Nouri-Vaskeh M, Sharifi A, Khalili N, Zand R, Sharifi A. Dyspneic and non-dyspneic (silent) hypoxemia in COVID-19: Possible neurological mechanism. Clin Neurol Neurosurg. 2020;198:106217. doi: 10.1016/j.clineuro.2020.106217. Epub 2020 Sep 9. PMID: 32947193;
34. Machado-Curbelo C. Silent or 'Happy' Hypoxemia: An Urgent Dilemma for COVID-19 Patient Care. MEDICC Rev. 2020;22(4):85-86. doi: 10.37757/MR2020.V22.N4.9.

Approach to Respiratory System Involvement and the Symptom of Dyspnea in Covid-19 Disease

Year 2021, Volume: 7 Issue: 3, 439 - 445, 31.12.2021

Gülsüm Hilal Demir Burcu Kayhan Tetik

https://doi.org/10.19127/mbsjohs.959305

Abstract

The Covid-19 pandemic, China at the end of 2019 and was declared a global pandemic by the World Health Organization on March 11, is still a serious public health problem. The international virus taxonomy committee named this virus as SARSCoV-2 and the disease caused by the virus as Covid-19 disease. The disease is transmitted from person to person through droplets. When the infected person coughs, sneezes, or speaks, the virus found in respiratory secretions is transmitted by direct contact with the mucosa. In addition, it can be transmitted upon bringing one’s hands to the mucous membranes of the mouth, nose, or eyes after hand-to-hand contact with droplets produced by the coughing and sneezing of a sick individual.
The respiratory system is the system most affected by Covid-19 infection. The virus affects the respiratory system in 3 ways: acute respiratory distress syndrome (ARDS) with diffuse alveolar damage, diffuse thrombotic alveolar microvascular occlusion, and inflammatory mediator-associated airway inflammation. As a result of these 3 effects of the virus, impaired alveolar oxygenation, hypoxemia, acidosis and, consequently, dyspnea develops. Dyspnea occurs when breathing becomes disturbingly noticeable. Dyspnea is an important symptom that affects the prognosis of Covid-19 disease. The severity of the disease ranges from asymptomatic infection to critical illness. Dyspnea symptoms and respiratory system involvement are more common in critical illness. Primary care physicians should be familiar with respiratory system pathologies caused by the Covid-19 disease.

Keywords

Covid-19, Dyspnea, Pandemic

References

1. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020, World Health Organization (WHO), https://www.who.int/dg/ speeches/detail/ who-director-general-s-opening-remarks-atthe-media-briefing-on-covid-19-11-march2020, (erişimtarihi: 01.05.2021).
2. J.AndréKnottnerus, Betweeniatrotropic stimulus and interiatric referral: the domain of primary care research,Journal of Clinical Epidemiology,Volume 55, Issue 12,2002,Pages 1201-1206,ISSN 0895-4356
3. Coronaviridae Study Group of the International Committee on Taxonomy of Viruses, the species severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2, Nat Microbiol 2020 Apr;5(4):536-544. doi: 10.1038/s41564-020-0695-z. Epub 2020 Mar 2 4. McIntosh K, Dees JH, Becker WB, Kapikian AZ, Chanock RM. Recovery in tracheal organ cultures of novel viruses from patients with respiratory disease. Proc Natl Acad Sci USA 1967;57:933-40.
5. T.R. Ministry of Health, General Directorate of Public Health: COVID-19 (SARS-CoV-2 INFECTION) GUIDE. Scientific BoardStudy, T.C. Ministry of Health 12 April 2020, Ankara
6. Indwiani Astuti and Ysrafil, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): An overview of viral structure and host response, Diabetes MetabSyndr. 2020; 14(4): 407–12.
7. Li G, Fan Y, Lai Y, Han T, Li Z, Zhou P. Coronavirus infections and immune responses. J Med Virol. 2020;92:424–32
8. Jing Yang, Ya Zheng, Xi Gou, Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis, Int J Infect Dis. 2020;94:91-95
9. Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, Latin American Network of Coronavirus Disease 2019-COVID-19 Research (LANCOVID-19). Electronic address: https://www.lancovid.org. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis. 2020;34:101623. doi: 10.1016/j.tmaid.2020.101623. Epub 2020 Mar 13.
10. Wong HYF, Lam HYS, Fong AH, Leung ST, Chin TW, Lo CSY, et al.. Frequency and Distribution of Chest Radiographic Findings in Patients Positive for COVID-19. Radiology. 2020;296(2):E72-E78. doi: 10.1148/radiol.2020201160. Epub 2020 Mar 27
11. Bernheim A. Mei X. Huang M. Chest CT findings in coronavirus disease-19 (COVID-19): relationship to duration of infection. Radiology. 2020:200463
12. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. Jama. 2020;323(13):1239–1242.
13. Wang Y, Wang Y, Chen Y, Qin Q. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID‐19) implicate special control measures. J Med Virol. 2020;1–9: 10.1002/jmv.25748
14. Zhou M, Zhang X, Qu J. Coronavirus disease 2019 (COVID-19): a clinical update. (2020) Front Med. 2020; 2. doi: 10.1007/s11684- 020-0767-8.
15. Gattinoni L, Chiumello D, Rossi S. (2020). COVID-19 pneumonia: ARDS or not? Crit Care, 24(1): 154. doi:10.1186/s13054-020- 02880-z
16. Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, Liu S, Zhao P, Liu H, Zhu L, Tai Y, Bai C, Gao T, Song J, Xia P, Dong J, Zhao J, Wang FS. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8(4):420-422. doi: 10.1016/S2213-2600(20)30076-X.
17. Wong CK, Lam CWK, Wu AKL, Plasma inflammatorcytokines and chemokines in severeacute respiratory syndrome. Clin ExpImmun, 2004;136(1):95-103.4
18. Ministry of Health, COVID-19 Adult Treatment Algorithm. Access date: 9 May 2021. Available from: https://covid19.saglik.gov.tr
19. Braithwaite S, Perina D. Dyspnea. In: Marx CA, editor-in-chief. Rosen's emergency medicine: concepts and clinical practice,7th ed. Philadelphia: Mosby Incorporated; 2010.
20. American Thoracic Society. Dyspnea Mechanisms, assessment, and management: A consensus statement. Am J Respir Crit Care Med 1999;159:321-40
21. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8(4):420-22. doi: 10.1016/S2213-2600(20)30076-X.
22. Zheng Z, Peng F, Xu B, Zhao J, Liu H, Peng J, Li Q, Jiang C, Zhou Y, Liu S, Ye C, Zhang P, Xing Y, Guo H, Tang W. Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. J Infect. 2020 Aug;81(2):e16-e25. doi: 10.1016/j.jinf.2020.04.021. Epub 2020 Apr 23.
23. Xu L, Mao Y, Chen G. Risk factors for 2019 novel coronavirus disease (COVID-19) patients progressing to critical illness: a systematic review and meta-analysis. Aging (Albany NY). 2020;12(12):12410-12421. doi:10.18632/aging.103383
24. Xie J, Covassin N, Fan Z, Singh P, Gao W, Li G, et al. Association Between Hypoxemia and Mortality in Patients With COVID-19. Mayo Clin Proc. 2020;95(6):1138-47. doi: 10.1016/j.mayocp.2020.04.006. Epub 2020 Apr 11. 25. Jain V, Yuan JM. Predictive symptoms and comorbidities for severe COVID-19 and intensive care unit admission: a systematic review and meta-analysis. Int J Public Health. 2020;65(5):533-546. doi:10.1007/s00038-020-01390-7
26. Erbay A, Long COVID: A New Definition, Bozok Tıp Derg 2020;10(4):111-114
27. Carfì A, Bernabei R, Landi F; for the Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent Symptoms in Patients After Acute COVID-19. JAMA. 2020;324(6):603-605.
28. Lerum TV, Aaløkken TM, Brønstad E, Aarli B, Ikdahl E, Lund KMA, et.al. Dyspnoea, lung function and CT findings three months after hospital admission for COVID-19. Eur Respir J. 2020 Dec 10:2003448. doi: 10.1183/13993003.03448-2020. Epub ahead of print. PMID: 33303540; PMCID: PMC7736755
29. Tobin MJ, Laghi F, Jubran A. Why COVID-19 Silent Hypoxemia Is Baffling to Physicians. Am J Respir Crit Care Med. 2020 Aug 1;202(3):356-360. doi: 10.1164/rccm.202006-2157CP. 30. Brouqui P, Amrane S, Million M, Cortaredona S, Parola P, Lagier JC, et. al. Asymptomatic hypoxia in COVID-19 is associated with poor outcome. Int J Infect Dis. 2021;102:233-238. doi: 10.1016/j.ijid.2020.10.067.
31. Banzett RB, Similowski T, Brown R.Addressing respiratory discomfort in the ventilated patient Tobin MJ.editor. Principles and practice of mechanical ventilation 3rd ed New York: McGraw-Hill Inc.2012;1265–1280.
32. Tobin MJ, Laghi F, Jubran A. Why COVID-19 Silent Hypoxemia Is Baffling to Physicians. Am J Respir Crit Care Med. 2020;202(3):356-360. doi: 10.1164/rccm.202006-2157CP
33. Nouri-Vaskeh M, Sharifi A, Khalili N, Zand R, Sharifi A. Dyspneic and non-dyspneic (silent) hypoxemia in COVID-19: Possible neurological mechanism. Clin Neurol Neurosurg. 2020;198:106217. doi: 10.1016/j.clineuro.2020.106217. Epub 2020 Sep 9. PMID: 32947193;
34. Machado-Curbelo C. Silent or 'Happy' Hypoxemia: An Urgent Dilemma for COVID-19 Patient Care. MEDICC Rev. 2020;22(4):85-86. doi: 10.37757/MR2020.V22.N4.9.

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Primary Language	English
Subjects	Health Care Administration
Journal Section	Review
Authors	Gülsüm Hilal Demir 0000-0001-8462-4723 Burcu Kayhan Tetik 0000-0002-3976-4986
Publication Date	December 31, 2021
Published in Issue	Year 2021 Volume: 7 Issue: 3

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Vancouver	Demir GH, Kayhan Tetik B. Approach to Respiratory System Involvement and the Symptom of Dyspnea in Covid-19 Disease. Mid Blac Sea J Health Sci. 2021;7(3):439-45.

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