Happy Hypoxia: The New Covid-19 Symptom

Dr. Liau
Dr. Liau

Functional Medicine

Many patients have described a condition known as “happy” hypoxia during this pandemic’s second wave. This phenomenon has puzzled doctors and healthcare workers worldwide as it is asymptomatic. It has been labelled as the prime killer because individuals are unaware of their illness until it is too late.

What is Happy Hypoxia?
Happy Hypoxia, also known as silent hypoxia, is a condition in which oxygen levels in the body are unusually low. However, despite the low blood oxygen levels, some patients appear to be functioning without serious issues or even shortness of breath. For example, an individual’s oxygen level may be below 90% but can still walk and talk like a healthy person. Therefore, patients are usually unaware that they are being deprived of oxygen and arriving at the hospital in a much worse health condition than expected.

It is different from normal hypoxia, whereby it is a situation in which there is insufficient oxygen in the blood and bodily tissues. This can’t be avoided even though blood flow in the body is normal. The difference between happy hypoxia and hypoxia is that if a person is suffering from hypoxia, when oxygen levels fall below 90% patients would begin to experience lethargy, confusion or mental disruptions, due to the lack of oxygen that is reaching the brain. If the blood oxygen level is lower than 80%, your body might not function properly. Hence, resulting in damage to vital organs in the body.

Happy Hypoxia Explained
In happy hypoxia, the depletion of oxygen happens rapidly, which leads to respiratory failure, causing sudden death in many patients without experiencing shortness of breath. Patients become breathless not because of a drop in oxygen levels but because of a simultaneous rise in carbon dioxide levels, which occurs when the lungs are unable to eliminate this gas properly. This happens because the virus causes the air sacs to collapse in individuals with Covid pneumonia, resulting in a decrease in oxygen levels. The lungs do not become stiff or heavy with fluid but still functions as normal, expelling carbon dioxide to avoid accumulation. As a result, patients do not experience shortness of breath.

Signs to look out for in Happy Hypoxia
Patients who are having happy hypoxia often shows light symptoms of Covid-19 Symptoms such as cough, sore throat and fever headaches before they start to experience other following additional symptoms:

  • Unable to take deep breaths. Pain and discomfort will be produced when inhaling, making it impossible to take a deep breath. Patient’s breathing may become more rapid when they start panicking.
  • Profuse sweating. If you are sweating excessively for no apparent reason, such as doing vigorous activities or being exposed to high temperatures, you might be having the condition.
  • Change of lips and skin colour from natural tone to blue. As the body tries to battle the disease, some patients may notice a change in their skin tone, changing from red to blue, known as cyanosis, where there is not enough oxygen in the body.

Early Detection of Happy hypoxia
Silent hypoxia may cause a patient to delay seeking emergency medical treatment until the condition has progressed to a life-threatening level. To prevent that from happening, monitoring your blood oxygen level at home is essential for early detection in order to prevent further deterioration.

Detect blood oxygen level by purchasing a pulse oximeter, which is a non-invasive device to measure oxygen levels in your blood by having it placed on the finger of the patient. During the reading, small laser beams travel through the blood in the finger to measure the quantity of oxygen. This is done by measuring the changes of light absorption in oxygenated or deoxygenated blood, determining your oxygen saturation. A regular pulse oximeter reading usually ranges from 95% to 100%. Values that lie below 95% are considered low as it indicates the need for supplemental oxygen.

Other methods to measure oxygen saturation without a pulse oximeter includes observing the respiratory rate and the capillary nail refill test.


Method 1: Observing the respiratory rate of an individual
Respiratory rate is the number of breaths a person takes per minute. An average person should be able to take 12 to 20 breaths in a minute in a normal state. It is abnormal for breathing less than 12 times or more than 20 times per minute. Please seek medical attention as soon as possible.


Method 2: The capillary nail refill test
Press your thumb, and if it returns to a healthy pink colour after about two seconds, it means that there is no hypoxia. Still, if it continues to appear purple or white, it is recommended to seek medical attention immediately.

With the rising cases of Covid-19 due to the new variants, people are advised to observe symptoms that are mentioned above and conduct tests from time to time to ensure a normal level of oxygen in the body. After all, ‘happy hypoxia’ is difficult to identify as it is asymptomatic. If you suspect that you have symptoms above, go to the hospital immediately to prevent further deterioration.

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