key: cord-326709-zr3ju2rz
authors: Allali, Gilles; Marti, Christophe; Grosgurin, Olivier; Morélot‐Panzini, Capucine; Similowski, Thomas; Adler, Dan
title: Dyspnea: the vanished warning symptom of COVID‐19 pneumonia
date: 2020-06-12
journal: J Med Virol
DOI: 10.1002/jmv.26172
sha: 
doc_id: 326709
cord_uid: zr3ju2rz

Since December 2019, the severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) has rapidly spread worldwide, challenging the clinician and focusing the entire globe on critical illness high mortality. This article is protected by copyright. All rights reserved.

hospitalized in the intensive care unit (ICU) in the Seattle region were directly admitted from home. 3 The value of dyspnea, as a warning symptom in COVID-19 pneumonia, therefore seems low. Yet, dyspnea has been strongly associated with a poor prognosis in the general population, in patients with chronic obstructive pulmonary disease, and also in patients surviving acute hypercapnic respiratory failure.

Dyspnea requires the cognitive and affective processing of interoceptive information arising from the respiratory system. This involves a cortical dimension that is well illustrated by interferences between dyspnea and cognition. In a randomized controlled study involving 40 healthy high-functioning young adults, we showed that experimental 

Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study

The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients

Covid-19 in Critically Ill Patients in the Seattle Region -Case Series

This article is protected by copyright. All rights reserved

The neuro-invasiveness-related "vanishing" dyspnea hypothesis illustrates this dichotomy of having severe hypoxemia without dyspnea and may explain the high mortality in COVID-19 patients admitted (too late) in the ICU.

Declaration of interest: All authors report no conflicts of interest.