Division of Palliative Medicine, Geneva University Hospitals, Geneva, Switzerland.
Independent Researcher, Udine, Italy.
Respiration. 2021;100(10):1016-1026. doi: 10.1159/000517400. Epub 2021 Jul 30.
Breathlessness, also known as dyspnoea, is a debilitating and frequent symptom. Several reports have highlighted the lack of dyspnoea in a subgroup of patients suffering from COVID-19, sometimes referred to as "silent" or "happy hyp-oxaemia." Reports have also mentioned the absence of a clear relationship between the clinical severity of the disease and levels of breathlessness reported by patients. The cerebral complications of COVID-19 have been largely demonstrated with a high prevalence of an acute encephalopathy that could possibly affect the processing of afferent signals or top-down modulation of breathlessness signals. In this review, we aim to highlight the mechanisms involved in breathlessness and summarize the pathophysiology of COVID-19 and its known effects on the brain-lung interaction. We then offer hypotheses for the alteration of breathlessness perception in COVID-19 patients and suggest ways of further researching this phenomenon.
呼吸困难，也称为呼吸急促，是一种使人虚弱且频繁出现的症状。有几项报告强调了在患有 COVID-19 的患者亚群中存在无呼吸困难的情况，有时被称为“沉默”或“愉快性低氧血症”。报告还提到，疾病的临床严重程度与患者报告的呼吸困难程度之间没有明确的关系。COVID-19 的大脑并发症已经得到了充分的证明，其急性脑病的患病率很高，可能会影响传入信号的处理或呼吸急促信号的自上而下调节。在这篇综述中，我们旨在强调与呼吸困难相关的机制，并总结 COVID-19 的病理生理学及其对脑-肺相互作用的已知影响。然后，我们为 COVID-19 患者呼吸困难感知的改变提出假设，并提出进一步研究这一现象的方法。
