• Philippe Brouqui, Sophie Amrane, Matthieu Million, Sébastien Cortaredona, Philippe Parola, Jean-Christophe Lagier, and Didier Raoult.
• Aix Marseille Université, IRD, MEPHI, Marseille, France; IHU-Mediterranée Infection, Marseille, France. Electronic address: philippe.brouqui@univ-amu.fr.
• Int. J. Infect. Dis. 2021 Jan 1; 102: 233-238.

ObjectivesDescribe and evaluate the outcome of a coronavirus disease-2019 (COVID-19) patient without shortness of breath.Design And MethodsWe retrospectively collected data from COVID-19 patients diagnosed and cared for in Marseille, France. We selected data from patients who at admission, had a low dose CT scanner, dyspnea status, and oxygen saturation available. Blood gas was analyzed in a sample subset of patients.ResultsAmong 1712 patients with COVID-19, we report that 1107 (64.7%) do not complain of shortness of breath at admission. The low-dose computed tomography (LDCT) scan showed signs compatible with pneumonia in 757/1,107 (68.4%) of patients without dyspnea. In a subset of patients who had underwent at least one blood gas analysis (n = 161) and presented without dyspnea at admission, 28.1% (27/96) presented with a hypoxemia/hypocapnia syndrome. Asymptomatic hypoxia was associated with a very poor outcome (33.3% were transferred to the ICU and 25.9% died).ConclusionThe absence of shortness of breath in an old patient with comorbidity merit medical attention and should not be considered as a good sign of well-being. The poor prognosis of asymptomatic hypoxia, highlight the severity of this mild clinical presentation. In these patients, pulse oximetry is an important mean to predict the outcome along with news score and LDCT scanner.Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.

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