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新型冠状病毒肺炎真的会影响氧合血红蛋白解离曲线吗?

Does COVID-19 really impact on the oxy-hemoglobin dissociation curve?

作者信息

Nóbrega Flávia, Mauad Vitor Augusto Queiroz, Borducchi Davimar Miranda Maciel

机构信息

Faculdade de Medicina do ABC Santo Andre Brazil.

出版信息

EJHaem. 2020 Oct 31;1(2):604-607. doi: 10.1002/jha2.126. eCollection 2020 Nov.

Abstract

The COVID-19 pandemic has had a crucial impact on lifestyle worldwide. In this way, many studies have been presented, leading to continuous revaluation and questioning of conducts and concepts. Such is the case of the Chinese study suggesting that the new coronavirus has the potential to code anomalous nonstructural proteins capable of dissociating the iron atom from the porphyrin structure, contributing significantly to the characteristic hypoxemia conditions of the disease. Considering the potential impacts of those findings, the current study aims to evaluate and measure the dissociation curve of oxy-hemoglobin in COVID-19 patients. The project consists of a retrospective cohort study with data regarding oximetry and hemoglobin levels collected from digital patients records. The correlation between the measures and estimated values by Spearmen test was 0.843 ( < .001). A multiple linear regression model was applied using measured SO2 as a predicted variable and hemoglobin, PO2, and pH levels as predictors. The coefficients were pH 0.16-0.31 ( < .001); PO2 0.52-0.66 ( < .001) and Hb 0.088-0.059 ( = .706). Despite its limitations, the present study suggests that, at least in situations of clinical severity, the proposed mechanism does not appear to be universal or to have a significant clinical impact.

摘要

新冠疫情对全球生活方式产生了至关重要的影响。通过这种方式,已经出现了许多研究,导致对行为和观念的不断重新评估和质疑。中国的一项研究就是如此,该研究表明新冠病毒有可能编码异常的非结构蛋白,这些蛋白能够使铁原子从卟啉结构中解离出来,这对该疾病典型的低氧血症状况有显著影响。考虑到这些发现的潜在影响,本研究旨在评估和测量新冠患者氧合血红蛋白的解离曲线。该项目包括一项回顾性队列研究,其数据来自数字化患者记录中的血氧饱和度测定和血红蛋白水平。通过斯皮尔曼检验得出的测量值与估计值之间的相关性为0.843(<0.001)。应用多元线性回归模型,将测量的SO2作为预测变量,将血红蛋白、PO2和pH水平作为预测因子。系数分别为pH 0.16 - 0.31(<0.001);PO2 0.52 - 0.66(<0.001)和Hb 0.088 - 0.059(=0.706)。尽管存在局限性,但本研究表明,至少在临床严重的情况下,所提出的机制似乎并非普遍适用,也没有显著的临床影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d672/9175707/45c405c849de/JHA2-1-604-g002.jpg

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