Hyperoxia and modulation of pulmonary vascular and immune responses in COVID-19
Hyperoxia and modulation of pulmonary vascular and immune responses in COVID-19
复制标题
DOI：
10.1152/ajplung.00304.2020
复制
发表时间：
2021-01-01
影响因子：
4.9
通讯作者：
Robson, Simon C.
中科院分区：
文献类型：
--
作者：
Hanidziar, Dusan;Robson, Simon C.
氧气是COVID-19住院患者最常用的治疗方法。在那些发生肺炎和急性呼吸窘迫综合征（ARDS）恶化的患者中，可能需要长时间给予高浓度氧气，通常与机械通气一起使用。高氧虽然可以挽救生命，并且对于在短期内维持足够的氧合是必不可少的，但可能对肺实质结构和功能产生不利的长期后果。高氧本身如何影响COVID-19中的肺部疾病，在很大程度上尚未探索。大量的实验研究已经证实高氧与有害的结果有关，包括免疫反应的紊乱、代谢功能异常以及血流动力学和肺泡屏障功能的改变。当暴露时间延长时，这些变化可能最终进展为临床上明显的肺损伤和不良重塑，并导致实质纤维化。考虑到严重COVID-19患者的高氧暴露可能是不可避免的，以维持生命，这些高氧后遗症叠加在SARS-CoV-2病毒的细胞病变效应上，可能会很好地影响COVID-19诱导的ARDS的发病机制。
Oxygen is the most commonly used therapy in hospitalized patients with COVID-19. In those patients who develop worsening pneumonia and acute respiratory distress syndrome (ARDS), high concentrations of oxygen may need to be administered for prolonged time periods, often together with mechanical ventilation. Hyperoxia, although lifesaving and essential for maintaining adequate oxygenation in the short term, may have adverse long-term consequences upon lung parenchymal structure and function. How hyperoxia per se impacts lung disease in COVID-19 has remained largely unexplored. Numbers of experimental studies have previously established that hyperoxia is associated with deleterious outcomes inclusive of perturbations in immunologic responses, abnormal metabolic function, and alterations in hemodynamics and alveolar barrier function. Such changes may ultimately progress into clinically evident lung injury and adverse remodeling and result in parenchymal fibrosis when exposure is prolonged. Given that significant exposure to hyperoxia in patients with severe COVID-19 may be unavoidable to preserve life, these sequelae of hyperoxia, superimposed on the cytopathic effects of SARS-CoV-2 virus, may well impact pathogenesis of COVID-19-induced ARDS.