Different Outcomes of “Silent Hypoxia” in Patients with COVID-19 Pneumonia: A Case Series and Literature Review

COVID-19 has been declared a pandemic since March 2020 and it has been responsible for millions of deaths worldwide. The SARS-CoV-2 causes a spectrum of diseases mainly affecting the respiratory system. It can also complicate other systems causing thromboembolic phenomena and myocardial ischaemia. A...

Full description

Saved in:
Bibliographic Details
Main Authors: Ashani Ratnayake, Prabhashini Kumarihamy, Sujeewa Gunaratne, Hiranya Abeysinghe, Sahan Perera, Shirley Ekanayake
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Critical Care
Online Access:http://dx.doi.org/10.1155/2021/1215274
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850165896570470400
author Ashani Ratnayake
Prabhashini Kumarihamy
Sujeewa Gunaratne
Hiranya Abeysinghe
Sahan Perera
Shirley Ekanayake
author_facet Ashani Ratnayake
Prabhashini Kumarihamy
Sujeewa Gunaratne
Hiranya Abeysinghe
Sahan Perera
Shirley Ekanayake
author_sort Ashani Ratnayake
collection DOAJ
description COVID-19 has been declared a pandemic since March 2020 and it has been responsible for millions of deaths worldwide. The SARS-CoV-2 causes a spectrum of diseases mainly affecting the respiratory system. It can also complicate other systems causing thromboembolic phenomena and myocardial ischaemia. An entity of hypoxia has been described in these patients which show no clinical signs and symptoms of respiratory distress despite being extremely hypoxic. This is called silent or happy hypoxia. The exact mechanism for this is not known. We report 4 cases which had similar presentations of silent hypoxia but had different course of illness and different outcomes. All 4 patients did not show any signs of respiratory distress, but had oxygen saturation less than 82%. 3 of them needed intensive care unit support for oxygen therapy and subsequently needed noninvasive ventilation. Only one required invasive ventilation. The fourth patient did not require intensive care support. The patient who required invasive ventilation succumbed due to severe COVID pneumonia whereas the other 3 patients were discharged from the hospital. Silent hypoxemia can go undetected in COVID-19 patients particularly in the time of a pandemic. This case series highlights the importance of meticulous clinical examination including oxygen saturation measurements in suspected or confirmed patients with COVID-19. The course of illness can be different in different populations, and this needs further clinical evidence.
format Article
id doaj-art-dc777d42cae64e53ba9f873354ecc99e
institution OA Journals
issn 2090-6420
2090-6439
language English
publishDate 2021-01-01
publisher Wiley
record_format Article
series Case Reports in Critical Care
spelling doaj-art-dc777d42cae64e53ba9f873354ecc99e2025-08-20T02:21:37ZengWileyCase Reports in Critical Care2090-64202090-64392021-01-01202110.1155/2021/12152741215274Different Outcomes of “Silent Hypoxia” in Patients with COVID-19 Pneumonia: A Case Series and Literature ReviewAshani Ratnayake0Prabhashini Kumarihamy1Sujeewa Gunaratne2Hiranya Abeysinghe3Sahan Perera4Shirley Ekanayake5District Base Hospital, Teldeniya, Sri LankaDistrict Base Hospital, Teldeniya, Sri LankaDistrict Base Hospital, Teldeniya, Sri LankaDistrict Base Hospital, Teldeniya, Sri LankaDistrict Base Hospital, Teldeniya, Sri LankaDistrict Base Hospital, Teldeniya, Sri LankaCOVID-19 has been declared a pandemic since March 2020 and it has been responsible for millions of deaths worldwide. The SARS-CoV-2 causes a spectrum of diseases mainly affecting the respiratory system. It can also complicate other systems causing thromboembolic phenomena and myocardial ischaemia. An entity of hypoxia has been described in these patients which show no clinical signs and symptoms of respiratory distress despite being extremely hypoxic. This is called silent or happy hypoxia. The exact mechanism for this is not known. We report 4 cases which had similar presentations of silent hypoxia but had different course of illness and different outcomes. All 4 patients did not show any signs of respiratory distress, but had oxygen saturation less than 82%. 3 of them needed intensive care unit support for oxygen therapy and subsequently needed noninvasive ventilation. Only one required invasive ventilation. The fourth patient did not require intensive care support. The patient who required invasive ventilation succumbed due to severe COVID pneumonia whereas the other 3 patients were discharged from the hospital. Silent hypoxemia can go undetected in COVID-19 patients particularly in the time of a pandemic. This case series highlights the importance of meticulous clinical examination including oxygen saturation measurements in suspected or confirmed patients with COVID-19. The course of illness can be different in different populations, and this needs further clinical evidence.http://dx.doi.org/10.1155/2021/1215274
spellingShingle Ashani Ratnayake
Prabhashini Kumarihamy
Sujeewa Gunaratne
Hiranya Abeysinghe
Sahan Perera
Shirley Ekanayake
Different Outcomes of “Silent Hypoxia” in Patients with COVID-19 Pneumonia: A Case Series and Literature Review
Case Reports in Critical Care
title Different Outcomes of “Silent Hypoxia” in Patients with COVID-19 Pneumonia: A Case Series and Literature Review
title_full Different Outcomes of “Silent Hypoxia” in Patients with COVID-19 Pneumonia: A Case Series and Literature Review
title_fullStr Different Outcomes of “Silent Hypoxia” in Patients with COVID-19 Pneumonia: A Case Series and Literature Review
title_full_unstemmed Different Outcomes of “Silent Hypoxia” in Patients with COVID-19 Pneumonia: A Case Series and Literature Review
title_short Different Outcomes of “Silent Hypoxia” in Patients with COVID-19 Pneumonia: A Case Series and Literature Review
title_sort different outcomes of silent hypoxia in patients with covid 19 pneumonia a case series and literature review
url http://dx.doi.org/10.1155/2021/1215274
work_keys_str_mv AT ashaniratnayake differentoutcomesofsilenthypoxiainpatientswithcovid19pneumoniaacaseseriesandliteraturereview
AT prabhashinikumarihamy differentoutcomesofsilenthypoxiainpatientswithcovid19pneumoniaacaseseriesandliteraturereview
AT sujeewagunaratne differentoutcomesofsilenthypoxiainpatientswithcovid19pneumoniaacaseseriesandliteraturereview
AT hiranyaabeysinghe differentoutcomesofsilenthypoxiainpatientswithcovid19pneumoniaacaseseriesandliteraturereview
AT sahanperera differentoutcomesofsilenthypoxiainpatientswithcovid19pneumoniaacaseseriesandliteraturereview
AT shirleyekanayake differentoutcomesofsilenthypoxiainpatientswithcovid19pneumoniaacaseseriesandliteraturereview