The Geek’s POV re Covid-19, Happy Hypoxia is Key

There are some elements of a Covid-19 infection and subsequent mortality that have a common theme that as a geek I think are worth looking into. That theme is “low blood oxygen saturation” or low “Pulse Ox.” When we look at some of the data around the risk factors that increase the chance of death with an infection we see factors that also seem to correlate with issues around getting oxygenated blood to every organ.

I’m not a scientist, nor do I play one on TV. I’m just a geek that has loved science since age 5, who after winning science fair prizes in HS, doing some dangerous experiments in my garage or back-yard and being a physics major as an undergrad realized it was easier to “invent stuff” as a geeky business-person than as a physicist. That worked out very well for me, and one of my inventions will power this site’s process of giving away 50% of ad revenue to causes readers choose.

But back to Covid-19. It’s been reported that long before the patients have visible breathing difficulty they already have a case of pneumonia that is fairly advanced. So, clinicians have started monitoring Pulse Ox as part of the diagnostic. It would be interesting to test if it may even be a better indicator than body temperature for infection.

Science Magazine reports that ‘happy hypoxia’ has clinicians perplexed with patients with moderate symptoms measuring blood-oxygen saturation levels that would ordinarily cause death and yet these patients were being admitted while mobile and with moderate symptoms.

Let’s look at the symptoms:

1. The “frostbite” on toes: to my geeky brain, could this be a symptom brought about by low blood oxygen saturation. Something that would show up sooner when combined with slightly poor circulation (diabetes-related, or other cardio-vascular diseases).
2. Starting off with low Pulse Ox: One study showed: “Obesity Is Associated With a Lower Resting Oxygen Saturation in the Ambulatory Elderly: Results From the Cardiovascular Health” So, the obese start with one strike
3. Diabetes and PVD or peripheral vascular disease. Again, your Pulse Ox may already be low and poor circulation exacerbates it
4. Before Covid-19 pneumonia in patients creates hypoxemia there are other illnesses that cause low blood oxygen saturation:
   • Anemia
   • ARDS (Acute respiratory distress syndrome)
   • Asthma
   • Congenital heart defects in children
   • Congenital heart disease in adults
   • COPD (chronic obstructive pulmonary disease) exacerbation — worsening of symptoms
   • Emphysema
   • Interstitial lung disease
5. The surge in Kidney Failure: Why is this a surprise? To my geeky brain, it’s not the virus causing the kidney failure. It’s the lack of oxygen (yet I haven’t seen it reported this way). Hypoxia: The Force that Drives Chronic Kidney Disease. So, the silent pneumonia that stikes the patient early and is only visible in CT Scans or careful examination is blowing out kidney too, all caused by the hypoxia.

Clinicians are also looking to tie the high frequency of blood clotting and strokes to what’s going on in the lungs early in the infections, and how small clots may be related to the hypoxia as well. Understanding these dynamics may assist in both early intervention and treatment.