PT  - JOURNAL ARTICLE
AU  - Federico Raimondi
AU  - Luca Novelli
AU  - Arianna Ghirardi
AU  - Mariangela Amoroso
AU  - Roberta Trapasso
AU  - Mauro Gori
AU  - Michele Senni
AU  - Chiara Allegri
AU  - Roberta Biza
AU  - Marisa Anelli
AU  - Caterina Conti
AU  - Gianluca Imeri
AU  - Gianmariano Marchesi
AU  - Ferdinando Luca Lorini
AU  - Fabiano Di Marco
TI  - Asymptomatic hypoxia in Covid-19
AID  - 10.1183/13993003.congress-2021.PA3259
DP  - 2021 Sep 05
TA  - European Respiratory Journal
PG  - PA3259
VI  - 58
IP  - suppl 65
4099  - http://erj.ersjournals.com/content/58/suppl_65/PA3259.short
4100  - http://erj.ersjournals.com/content/58/suppl_65/PA3259.full
SO  - Eur Respir J2021 Sep 05; 58
AB  - Background: A bewildering aspect of Covid-19 is the presentation of a proportion of patients with respiratory failure, but no perception of dyspnea. The aim of this study was to investigate frequency, characteristics and outcomes of Covid-19 patients with asymptomatic hypoxia compared with a symptomatic severity-matched group. Methods: patients were hospitalized at ASST Papa Giovanni XXIII, in Bergamo, Italy, from February 23rd to April 7th 2020. Data were derived from electronic medical records. Results: 1316 Covid-19 patients were evaluated, a third of them (N 469, 35.6%) did not report dyspnea at hospital admission. Overall 28-days mortality was 26.9% (N 354). In the unmatched analysis, patients with dyspnea had a more severe respiratory failure and a higher 28-day mortality (29.3% vs. 22.6%, p=0.009). The matching analysis led to the identification of two groups of dyspneic (N = 254), and not dyspneic (N = 254) patients with comparable radiological impairment, and respiratory failure severity at admission (median PaO2/FiO2 ratio of 229 [135 - 286], bilateral chest X ray involvement in 81.1% of them). In matched analysis, 28-day mortality resulted similar (26.4% vs. 21.7%, p=0.21), while endotracheal intubation (ETI) rate resulted significantly higher in patients with shortness of breath at admission (17.7% vs. 10.2%, p=0.015). Conclusions: In Covid-19, up to a third of the patients could be asymptomatic for dyspnea on admission. Dyspneic patients at presentation generally have worst clinical outcomes and higher mortality when compared to those without breathlessness. However, when patients are matched for severity at presentation, mortality is similar between groups, in spite of a lower ETI rate during hospitalization for not dyspneic patients.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3259.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).