Causes and Consequences of Hypoxia/Hypoxemia due to COVID-19: A Narrative Literature Review

COVID-19 is the third pandemic disease with respiratory manifestations after severe acute respiratory syndrome (SARS-Cov) and Middle East respiratory syndrome (MERS-Cov). One of the problems of patients with SARS-CoV2 infection is hypoxia and hypoxemia, which is considered to be seriously life-threatening. Given that there is not sufficient consensus to causes and consequences of hypoxia/ hypoxemia, therefore this study was conducted to review the causes and consequences of hypoxia/hypoxemia due to COVID-19.

This narrative review study was done through a library literature review in the databases including Science direct, Scopus, EMBASE ،Web of Science ، PubMed, SID, WHO, CDC, Springer, Elsevier and Google Scholar search engine in Persian and English 2019 to 2022. Articles were evaluated and selected based on the inclusion and exit criteria, first duplicate articles by title review and then unrelated articles are deleted through review abstract and finally, the articles analysis and them which were not consistent with the purpose of study were excluded.   

Out of 1275 searched articles, 42 were selected and analyzed. The results showed that lung injuries, activation of immune system and induction of inflammatory reactions, Central nervous system injuries and underlying diseases are the causes of hypoxia and hypoxemia. Brain and nerve damages, gastrointestinal disorders, heart damages and liver damage can be caused by hypoxia and hypoxemia and delirium, encephalopathy, encephalitis, seizures and kidney damage caused by hypoxia.

Although respiratory infection is more common in patients with Covid 19, some patients suffer from hypoxia or hypoxemia and the side effects associated with both. In order to cause oxygen homeostasis, early detection and therapeutic interventions are essential that during oxygen therapy, secondary injuries of this therapeutic intervention should be considered. Investigate the level of inflammatory and immune markers, may help in early detection them in patients.