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Yusup Dwiyanto

Stimik Sinar Nusantara,Indonesia

Title: Happy" Hypoxemia in COVID-19

Biography

Biography: Yusup Dwiyanto

Abstract

Coronavirus disease (COVID-19) is caused by SARS-COV2 and represents the causative agent of a potentially fatal disease that is of great global public health concern. The first cases were reported in December 2019. The main clinical symptoms that appear are fever (temperature > 38oC), cough and difficulty breathing. It can also be accompanied by severe shortness of breath, fatigue, myalgia, gastrointestinal symptoms such as diarrhea and other respiratory symptoms. Silent Hypoxemia is a crippling and sometimes fatal complication of this disease. Patients do not show symptoms such as shortness of breath or cough, but when examined the levels of oxidation can down and risk of acute respiratory distress syndrome (ARDS) and organ failure

Case Presentation

  1. 56-year-old male patient came to the emergency room with complaints of shortness of breath since 2 days ago with a dry cough, fever which was also felt since 2 days ago. There is no history of lung disease (asthma, pulmonary tuberculosis, etc.), DM, hypertension is also denied. Physical examination found TD 154/105

mmHg, HR 109x / min, RR 20x / min, Temperature 38oC with 99% SpO2, retraction of lung + / + minimal, rhonki + / +, others are within normal. In addition, a complete blood test was performed, the thorax photo with the following results was leukocytes 7.7 thousand / µL, Hb 15.3 g / dL, Ht 43%, Platelets 167 thousand/µL and thoracic photos were found to increase bronchovascular patterns with the appearance of acute bronchitis. . The patient is then allowed to go home.

few days later the patient came with the same complaint accompanied by abdominal pain and defecation >5x/day. From the physical

examination found TD 116/89 mmHg, HR 96x / min, RR 18x / min, Temperature 38.7oC with 95% SpO2, retraction lung + / + minimal, rhonki + / +, others are within normal. Investigations were carried out in the form of complete blood, chest radiograph and CT scan without contrast with the following results: leukocytes 3.3 thousand / µL, Hb 14.2 g / dL, Ht 40%, platelets 122 thousand / µL, Diff Count (0/0/0/80 / 15/5), NS 1 Negative, chest radiograph found bilateral pneumonia with CT scan results showed a ground glass opacity. In addition, PCR tests on patients with positive results. So patients are treated in isolation and monitored for several days.

The patient was then monitored within 3 days with the following details, on the first day the patient still complained of fever, dizziness, nausea, shortness of breath and diarrhea. But here patients can still move to take care of themselves properly. On physical examination TD 151/86 mmHg, HR 75x/minute, RR 18x/minute, Temperature 37.1oC with SpO2 99%, retraction lung + / + minimal, rhonki + / +, others are within normal. The results of the following investigations were leukocytes 4.0 thousand/µL, Hb 14.7 g/dL, Ht 41%, platelets 146 thousand/µL, Diff Count (0/0/3/75/16/6), Blood Gas Analysis (pH 7.52, pCO2 25 mmHg, pO2 53 mmHg, HCO3 20 mmol / L, Total CO2 21 mmol / L, O2 Saturation 91%, BE -0.2 mEq / L),