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Reminder of important clinical lesson
Case report
Silent hypoxia: a frequently overlooked clinical entity in patients with COVID-19
  1. Atanu Chandra,
  2. Uddalak Chakraborty,
  3. Jyotirmoy Pal and
  4. Parthasarathi Karmakar
  1. Internal Medicine, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
  1. Correspondence to Dr Atanu Chandra; chandraatanu123{at}gmail.com

Abstract

COVID-19 caused by SARS-CoV-2 may present with a wide spectrum of symptoms ranging from mild upper respiratory tract infection like illness to severe pneumonia and death. Patients may have severe hypoxaemia without proportional features of respiratory distress, also known as ‘silent’ or ‘apathetic’ hypoxia. We present a case of a 56-year-old man with COVID-19 who presented to the fever clinic of our institution with fever and cough without any respiratory distress but low oxygen saturation. The patient deteriorated over the next 2 days but eventually recovered of his illness in due course of time. This case demonstrates ‘silent hypoxia’ as a possible presentation in COVID-19 and emphasises the importance of meticulous clinical examination including oxygen saturation measurements in suspected or confirmed patients.

  • infectious diseases
  • pneumonia (respiratory medicine)
  • lung function

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2020-237207

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    Footnotes

    • Contributors AC prepared the manuscript with adequate planning and execution; he also collected data regarding the patient. The case report is designed and conceptualised by him. UC was a direct care giver to the patient, who managed the case actively and collected relevant data on investigations with equal contributorship. He also helped in preparing the manuscript. His planning and analysis of the case helped in formulating the report. JP helped in detailed supervision, final output and review of literature regarding the manuscript. PK supervised the entire management of the patient and has actively contributed in editing the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.