Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 Oct;38(10):2243.e5-2243.e6.
doi: 10.1016/j.ajem.2020.05.044. Epub 2020 May 22.

Silent hypoxia: A harbinger of clinical deterioration in patients with COVID-19

R Gentry Wilkerson  1 , Jason D Adler  2 , Nirav G Shah  3 , Robert Brown  4
Affiliations
Case Reports

Silent hypoxia: A harbinger of clinical deterioration in patients with COVID-19

R Gentry Wilkerson et al. Am J Emerg Med. 2020 Oct.

Abstract

Patients infected with the SARS-CoV-2 virus can present with a wide variety of symptoms including being entirely asymptomatic. Despite having no or minimal symptoms, some patients may have markedly reduced pulse oximetry readings. This has been referred to as "silent" or "apathetic" hypoxia (Ottestad et al., 2020 [1]). We present a case of a 72-year-old male with COVID-19 syndrome who presented to the emergency department with minimal symptoms but low peripheral oxygen saturation readings. The patient deteriorated over the following days and eventually died as a result of overwhelming multi-organ system failure. This case highlights the utility of peripheral oxygen measurements in the evaluation of patients with SARS-CoV-2 infection. Self-monitoring of pulse oximetry by patients discharged from the emergency department is a potential way to identify patients needing to return for further evaluation.

Keywords: COVID-19; SARS-CoV-2; Silent hypoxia.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Portable anteroposterior chest radiograph (CXR) demonstrating perihilar pulmonary opacities bilaterally.
See this image and copyright information in PMC

References

    1. Ottestad W., Seim M., Mæhlen J.O. COVID-19 with silent hypoxemia. Tidsskr Nor Laegeforen. 2020;140(7) doi: 10.4045/tidsskr.20.0299. - DOI - PubMed
    1. Zhu N., Zhang D., Wang W. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727–733. doi: 10.1056/NEJMoa2001017. - DOI - PMC - PubMed
    1. Wu Z., McGoogan J.M. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020 doi: 10.1001/jama.2020.2648. February. - DOI - PubMed
    1. Hoffmann M., Kleine-Weber H., Schroeder S. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020;181(2):271–280.e278. doi: 10.1016/j.cell.2020.02.052. - DOI - PMC - PubMed
    1. Hamming I., Timens W., Bulthuis M.L.C., Lely A.T., Navis G.J., van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004;203(2):631–637. doi: 10.1002/path.1570. - DOI - PMC - PubMed

Publication types