COVID’S Silent Hypoxia

May 10, 2020 Joe Brady

Once upon a time, a student asked his Tai Chi teacher “ master, what is the secret to living a long healthy life” the Tai Chi teacher thought about it for a while and then replied, “ just keep breathing”.

One phenomenon puzzling doctors treating patients with COVID-19 is called “silent hypoxia”. Many patients appear in the emergency room who are not exhibiting breathlessness, they are alert and talking and yet can have dangerously low levels of blood oxygen. 

If you get sick with COVID you can’t always tell if you are not breathing in enough oxygen. Like a thermometer, a pulse oximeter should be part of every medicine chest.

Blood Oxygen Saturation

COVID-19 Differences
Some coronavirus patients can show up in the emergency room with a pulse oximeter reading of as low as 66%, and still be breathing fine and don’t appear to be that sick. At that level, under normal circumstances, the patient would almost invariably be put on a ventilator and with COVID that may not turn out well. Somewhere between 80-90% of patients that are put on a ventilator usually die. What happens is that the virus infection interferes with the lung’s ability to absorb oxygen, but does not reduce the body’s ability to exhale carbon dioxide. It’s a buildup of carbon dioxide that signals the brain to start feeling breathlessness, so with this infection, you may not feel breathlessness while in the background your oxygen is dropping like a rock. 

Qing Qi or the energy that our bodies get from oxygen is vital for life. Concentrations of oxygen must remain at fairly high levels to provide enough energy for life to each of the cells in the body.

  1. Normal blood oxygen saturation levels are between 94-97 % for healthy people. 
  2. A blood oxygen saturation level of 90% is concerning
  3. Anything below 90% is considered a health emergency. 
  4. A blood saturation level in the low 80’s can result in tissue damage and is life-threatening. 

ER Treatments Deviate from the Norm

In an interview with Business Insider, Dr. Trevor Pour, an emergency-medicine physician at Mount Sinai Health System, told reporters “We started treating this as a knee-jerk intubation-ventilation process because that’s what we’ve done with people who have such profoundly low oxygen levels.” 

“Patients who aren’t struggling to breathe may recover with simple oxygen treatment rather than a ventilator, even if their blood-oxygen levels are low,” Dr. Astha Chichra, a critical-care physician at Yale School of Medicine, told Live Science. Chichra went on to say “The key difference we’ve found between these folks is that the people who are working hard to breathe are the folks who usually need to be intubated.”



A Pulse Oximeter might help save lives

A fairly inexpensive device, called a pulse oximeter, can detect changes in blood oxygen levels even when the patient appears to be breathing normally. Just like a thermometer, a pulse oximeter should be part of every medicine chest and first aid kit.

If you can detect a drop in blood oxygen concentrations before they become critical, you can get yourself to the emergency room in a timely manner that may keep you off a ventilator.  If you get to the ER quickly, oxygen therapy may be enough to treat you until the immune system can get the upper hand, and you can begin to recover. 

If you have what seems to be an unusually low reading, call your doctor first to make sure you are not misreading it. You can buy a pulse oximeters at any drug store and they are extremely reliable. However, if the battery is low or if it is cold outside, you can get a false reading, so, again, check with your doctor before heading to the ER.

Remember, do not wait too long before having someone drive you to the ER. Getting to the emergency room before oxygen levels drop too far can determine whether the doctors can save your life or not.