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Covid-19 and "happy hypoxia": mysterious symptom of the disease

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An American study observed that some patients affected by Covid-19 had very low oxygen saturation without showing signs of respiratory distress. This strange phenomenon is known as "happy hypoxia" and it is not without consequences for health.


Covid-19 can manifest itself as a cough, fever, headache, or loss of taste and smell. In the most severe cases, some patients are affected by respiratory distress. They then have hypoxia, that is, a particularly low oxygen saturation, which makes them generally incoherent, comatose, or even unconscious. So, your health is critical. But some Covid-19 patients with very low oxygen saturation simply complain of shortness of breath. This is what some have called "happy hypoxia."

What is hypoxia?

Hypoxia refers to a lack of oxygen supply. Oxygen reaches the lungs through the air we breathe. It passes into the bloodstream and attaches itself to red blood cells before being transported to the rest of the body and supplying vital organs such as the brain, heart, and muscles. When oxygen supply is low, this is characterized in particular by very low oxygen saturation, which is the amount of oxygen circulating in the blood.

But in some cases, a mysterious phenomenon occurs, highlighted in particular by the American scientific journal Science: Covid-19 patients with very low oxygen saturation present to the hospital simply complaining of labored breathing. This is what some have called "happy hypoxia," an inappropriate phrase given the seriousness of the situation. The correct term to describe this phenomenon is "silent hypoxia."

On CNN, Dr. Richard Levitan, an American emergency room physician, says he has seen patients enter with blood oxygen levels so low that they should have been unconscious. Normal oxygen saturation is between 95% and 100%. When it is below 90%, it is considered abnormal.

Some of the patients treated by Dr. Richard Levitan had an oxygen saturation of 50%. "Their lung X-rays were horrible, their oxygen levels terrible, and yet they were wide awake and alert on their cell phones. Everyone said they had been a little sick for days and had recently noticed shortness of breath, or fatigue, or something else, "he explained.

A phenomenon that causes potential harm to the body.

How to explain that these patients do not realize at all that their state of health has deteriorated so much? "We would not observe this phenomenon in the context of influenza or community acquired pneumonia. It is much deeper and an example of a very abnormal physiological mechanism that takes place before our eyes ... We just do not understand," he told The Guardian Dr. Mike Charlesworth, an anesthesiologist at Wythenshawe Hospital in Manchester.

Some doctors assume that when Covid-19 patients develop shortness of breath, the body quickens breathing to compensate, while blood oxygen levels continue to drop. The body then adapts to this change, just as it adapts to height.

Although silent, this hypoxia can cause damage to the lungs, but also to other organs such as the heart, kidneys, and brain. How to avoid it? Some doctors are suggesting that providing a pulse oximeter, which measures oxygen saturation at the fingertip, to patients who test positive for Covid-19 may be a solution. But it has its limits, because they do not know if the early detection of this hypoxia would be enough to prevent the damage that is done to the body.

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