the invisibility of covid-19's 'happy hypoxia'

at this point, covid-19 is so much more than a respiratory illness. week by week, doctors are discovering new ways the novel coronavirus affects the body. but of all the new and surprising symptoms that have appeared — such as strokes and blood clotting  and in children, the rare kawasaki disease and purple toe rashes — ‘silent hypoxia’ might be the most confusing.

on figure 1, the medical sharing app, there are reports of covid-19 patients admitted into the emergency department talking and seeming perfectly alert but with oxygen levels in the 60s.

although a patient may not at all appear ill or show any signs of having trouble breathing, their chest x-ray can show “dangerously low oxygen levels and terrible pneumonia,” writes dr. richard levitin, an emergency physician in new york city, in an op-ed for the new york times.

the patients levitin met were still talking and scrolling on their phones, yet had such low oxygen-saturation levels that were “seemingly incompatible with life.” his concern was that by the time patients did have trouble breathing and presented to the emergency department, their condition had exacerbated to the point of requiring a ventilator — where breathing feels impossible and the mortality rate is extremely high .

what causes silent hypoxia?

there are several hypotheses what causes silent hypoxia in people with covid-19. some think the lungs are affected by blood clotting the lungs , which sets off proteins that prevent the blood from getting its necessary oxygen. it’s also possible that silent hypoxia could be a slow and steady decline in oxygen that patients acclimatize to the reduce oxygen and don’t notice, similar to how hikers acclimatize to higher altitudes. but all this is still not known .

with many patients afraid to visit a hospital , home monitoring (with the consultation of a family physician via telemedicine) could help early detection and prevent exacerbated conditions.

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the invisibility of covid-19's 'happy hypoxia'

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