Doctors who are treating coronavirus patients are baffled with a strange phenomenon called "happy hypoxia." According to reports, this condition appeared on some coronavirus patients who describe themselves as comfortable despite having low oxygen levels and would usually leave them unconscious, or even dead.

New mysterious condition

The condition appears to defy biology and it is raising questions about how coronavirus attacks the lungs. A healthy person's blood-oxygen saturation is at least 95%, while coronavirus patients have blood-oxygen saturation of 80% or 70%, with some extreme cases that drop to 50%.

However, these "happy hypoxics" have been observed checking their phones, talking to their health care providers, and describing themselves as comfortable. Dr. Reuben Strayer, an emergency physician at Maimonides Medical Center in Brooklyn, said that there is a mismatch between what they see on the monitor and what the patient looks like in front of them.

Strayer stated that he and other doctors are now seeking to understand the unusual condition, which he first noticed in coronavirus patients in March when they were streamed into his ER. Dr. Jonathan Bannard-Smith, a critical care specialist at the Manchester Royal Infirmary in the UK, said that some patients are unaware that their oxygen saturation is low.

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Another British physician pointed out that those who appear to be very ill with other lung conditions do not experience "happy hypoxia" since those with pulmonary embolism and pneumonia won't sit up in their bed to talk. However, this is not the case for most coronavirus patients as they do not seem to be having any difficulties nor they don't seem to exhibit any illness at all.

Theories about happy hypoxia

During the early phase of the coronavirus, low saturation levels are not always accompanied by obvious respiratory difficulties. In fact, the WHO and CDC pointed out that coronavirus causes chills, body aches, and constant coughing. According to Dr. Elnara Marcia Negri, a pulmonologist at Hospital Sirio-Libanes in Sao Paulo, Brazil, carbon dioxide levels can be normal and deep breathing may be comfortable for some coronavirus patients.

Dr. Negri said that the lung is inflating so the patients feel fine, though their oxygen saturation can be 70%, 60%, 50%, or even lower. There are theories about what causes the odd "happy hypoxia" since a lot of doctors are recognizing clotting as a major feature of severe COVID-19 cases.

Dr. Negri believes that a bit of clotting might start in the lungs, or it could be a result of an inflammatory reaction in the patient's fine blood vessels, which could trigger a cascade of proteins that prompts the blood to clot. Dr. Strayer also finds it reasonable to imagine that hypoxia may be caused when small blood vessels of the lung are being showered with clots.

Strayer's hospital and others are beginning to test a lot of coronavirus patients for markers of excess blood clotting and treat those who show it with blood thinners. However, Strayer stressed that it is not known whether clotting causes happy hypoxia. An imaging of a patient with hypoxic showed a waxy-looking film all around the lungs, and doctors do not know what it is.

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