Suffice it to say, asymptomatic hypoxia is not specific for Covid-19. Rather, it would be just about as useful as finding someone with an elevated temperature.
I think the general thought is that a finding of asymptomatic low oxygen saturation is not a specific finding just for Covid-19 - it's not specific.
My initial thought was along that line, that it could be a clue, in the same way fever, cough, and shortness of breath are clues (and yet non-specific).
I did not mean to suggest it was a substitute for a PCR test.
However if a pulse oximeter is accurate and a person does have a sustained abnormal low oxygen level, does that not argue for prompt investigation, virus or not?
Some comments on the NYT article complain that early detection does no good, if the hospital's advice is for all non-severe cases to say home anyway, and there is no officially approved effective treatment at this time. However IF it is true that sustained low blood oxygen and rapid breathing will contribute to deterioration in the lungs and/or other organs for those who do have COVID-19, then is it reasonable to suppose that supplemental O2 and/or other therapy at an early stage could be a benefit in those cases?
I live in an area that has a lot of COVID-19 cases right now and the hospitals here are not taking the cases they see as non-severe. Especially if they are younger and seemingly in good health without comorbid illness. However, if somebody who is actually having trouble breathing and is not otherwise able to articuate whats happening, is talking with them on the phone and they have additional information like a low oxygen saturation rate, that may be able to get them admitted - because its a quantitative measurement. Otherwise they turn them away telling them to call back and ask them again if it gets worse. The problem is sometimes they get worse very quickly and nobody knows why.
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One aspect of COVID-19 which is not getting media attention is the
neuroinvasive aspect of it.
The SARS-CoV-2 virus like other coronaviruses, can and does use axonal propagation to gain ingress into the brain where it may infect the brainstem which can affect the ability to breathe automatically. Also it is a separate infection in many ways from the one in the rest of the body, like the lungs. So the state of the lungs may not be representative of this other life threatening infection because of the separation between the two. People lose their autonomous breathing - suddenlly, sometimes. It is usually several days in and this happens to both young and old
It even happens sometimes when peoples lungs are not so badly infected or even infected at all. because it can infect the olfactory sensor neurons or cells in the cribiform palate that are able to serve as a pathway into the brain. There have been a lot of reports of people losing their sense of smell - As somebody who had asnomia happen (for about a year, decades ago) - not due due to COVID-19, due to toxic black mold (it returned eventually) this kind of thing is something I studied a lot to try to figure out what was going on then, and maintained an interest in since then. .
So I am particularly interested in this aspect of COVID-19.
One nurse who was infected described it like this. She felt as if she needed to stay awake because
she had lost her natural breath, I think the thing to take away is that we would be wise to hospitalize everybody who came down with COVID-19 who had any neurological signs like losing their sense of smell. They need some way of monitoring people who live alone or maybe everybody who is sick -
some mass produced device that can wake people up and get them to start breathing again and call the ambulance if they stop breathing. Otherwise people die in their sleep when they were told to wait it out at home, here in the US, large numbers of people are dying at home because of this mess.
And this is an astronomical loss to society. We have to do much better than we are doing.
Its NOT the medical professions fauilt, we need to face the reality that this kind of thing is going to happen more and more due to the rising levels of interconnectedness and we have to make it our business to respond to it with science.
I personally am trying to get the medical profession to look at a particular substance, one thats found in wine, peanuts, grapes, blueberries and an invasive plant that people comonly go nuts trying to eradicate, as a potential aid to this illness. Its already in the supply chain. It's the best known of the stilbenoid polyphenols. It was literally the first thing that came into my head when I heard what COVID-19 was doing. (Because it has all sorts of activities against things like sepsis and the verious respiratory issues caused by (symptoms) caused by other pathogens so much that it seemed a represent a remarkable match AS FAR AS I COULD TELL, superficially, it seemed to match closely to the problems COVID-19 causes) BUT, not being a doctor I have to say, sick people should not take it or anything else that they dont have medical advice is safe, when they are sick, please don't take it rely on doctors even though its remarkably safe in healthy people, considering the issues it often seems to improve.
There is a missing hole in our knowledge there.
It was shown to inhibt either one or both of the other two most closely related betacoronaviruses - in vitro, and it also does with many others. Its been used successfully in animal experiments for example, in piglets when put into their feed, preventing potentially fatal infections with pseudorabies virus. Piglets treated with it survived while others died.
Its cheap enough to be looked at as a replacement for antibiotics in agriculture. So the manufacturing capability is there.
We need to think outside of the box.
So, to return to my original thought, we should improve our ability to monitor sick people and make calling the doctor automatic, and then we can safely allow them to stay at home unless they are really in need of care and then give it to them. Because we'll know that if their respiratory ability starts failing at night because of COVID-19 invading their CNS a few days in, that will summon help.
And before and while they are sick we can give them things to reduce the disease severity even if not a silver bullet they could likely reduce the deaths and injuries a great deal. Whatever works, We should be doing our best to figure out what works.