SARS-CoV-2 phenotypes
The following illustrations (click to enlarge) summarise the proposed phenotypes of hypoxaemic patients with COVID-19. Extraordinarily, these patients exhibit at first an almost exclusive hypoxaemic respiratory failure, which respond very difficulty to high fractions of oxygen. The true cause is still unclear. We know there may be vascular and inflammatory abnormalities which make the pulmonary disease progress from a hypoxaemic viral pneumonia to ARDS.
Some experts divide patients in two separate phenotypes: The “L” phenotype characterized by a hypoxemic failure and “low elastance” lungs (high compliance) and the “H” phenotype with “high elastance and recoil” lungs (lower compliance).
References:
- Pederson SF, Ho Y-C. SARS-CoV-2: a storm is raging. J Clin Invest 2020
- Siddiqi HK, Mehra MR. COVID-19 Illness in Native and Immunosuppressed States: A Clinical-Therapeutic Staging Proposal, Journal of
- Heart and Lung Transplantation (2020), doi: https://doi.org/10.1016/j.healun.2020.03.012
- Gattinoni L et al. COVID-19 pneumonia: different respiratory treatment for different phenotypes?
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Medical Illustration
Peruvian Emergency medicine and Family Physician, living and working in Spain. Reformed English teacher and developing artist | SketchbookMD | Twitter |