Ramos CD, Fernandes AP, Souza SPM, Fujiwara M, Tobar N, Dertkigil SSJ, Takahashi MES, Gonçales ESL, Trabasso P, Zantut-Wittmann DE. Simultaneous Imaging of Lung Perfusion and Glucose Metabolism in COVID-19 Pneumonia. Am J Respir Crit Care Med. 2021 Feb 26. doi: 10.1164/rccm.202007-2944IM. Epub ahead of print. PMID: 33636089.
Severe hypoxemia in some patients with COVID-19 has been related to loss of hypoxic pulmonary vasoconstriction [1,2]. A 77-year-old male with 6 days of mild respiratory symptoms and no comorbidities was admitted with signs of respiratory failure (PaO2/FiO2: 61mmHg/0.36=169.4mmHg, reference values: RV=400-500mmHg). Chest CT showed extensive ground-glass opacities (50-75% right and 25-50% left lung involvement). Laboratory showed: D-Dimer=652ng/mL (RV<500ng/mL), C-reactive-protein=93.5mg/dL (RV<0,1mg/dL). Nasopharyngeal swab test (RT-PCR) confirmed COVID-19. The standard institutional protocol was initiated with nasal oxygen catheter (4.0L/min), antibiotics, dexamethasone and enoxaparin. The patient required invasive ventilation on the 10th day and died on the 35th day of hospitalization.
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