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Observational Study
. 2020 Nov;191(3):390-393.
doi: 10.1111/bjh.17128. Epub 2020 Oct 10.

A left shift in the oxyhaemoglobin dissociation curve in patients with severe coronavirus disease 2019 (COVID-19)

Dominik J Vogel  1 , Federico Formenti  2   3 , Andrew J Retter  1 , Francesco Vasques  1 , Luigi Camporota  1   2
Affiliations
Observational Study

A left shift in the oxyhaemoglobin dissociation curve in patients with severe coronavirus disease 2019 (COVID-19)

Dominik J Vogel et al. Br J Haematol. 2020 Nov.

Abstract

Critically ill patients with coronavirus disease 2019 (COVID-19) present with hypoxaemia and are mechanically ventilated to support gas exchange. We performed a retrospective, observational study of blood gas analyses (n = 3518) obtained from patients with COVID-19 to investigate changes in haemoglobin oxygen (Hb-O2 ) affinity. Calculated oxygen tension at half-saturation (p50 ) was on average (±SD) 3·3 (3·13) mmHg lower than the normal p50 value (23·4 vs. 26·7 mmHg; P < 0·0001). Compared to an unmatched historic control of patients with other causes of severe respiratory failure, patients with COVID-19 had a significantly higher Hb-O2 affinity (mean [SD] p50 23·4 [3·13] vs. 24·6 [5.4] mmHg; P < 0·0001). We hypothesise that, due to the long disease process, acclimatisation to hypoxaemia could play a role.

Keywords: haemoglobin; infection; oxygen affinity.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig 1
Fig 1
Distribution of p50 values calculated using Hill equation (Eq. 1) from measured pO2 and SO2 (n = 3518). Blue indicates left shift and red indicates right shift of oxyhaemoglobin affinity from the standard p50 value. Dashed line at 26·7 mmHg indicates standard value for p50. [Colour figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

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