Open Access, Volume 2 Silent hypoxaemia in COVID-19: Journey through ICU Clinical Image www.jcimcr.org Journal of Clinical Images and Medical Case Reports Received: Aug 05, 2021 Accepted: Sep 13, 2021 Published: Sep 20, 2021 Archived: www.jcimcr.org Copyright: © Kumarihamy P (2021). *Corresponding Authors: Prabhashini Kumarihamy Consultant Physician, Specialised COVID-19 Treatment Unit, Base Hospital, Teldeniya, Sri Lanka. Email: prabhashinikumarihamy@yahoo.com ISSN 2766-7820 Ashani Ratnayake 1 ; Prabhashini Kumarihamy 2 *; Sujeewa Gunaratne 2 ; Hiranya Abeysinghe 2 ; Sahan Perera 2 ; Shirley Ekanayake 3 1 Consultant Anaesthetst, Specialised COVID-19 Treatment Unit, Base Hospital, Teldeniya, Sri Lanka. 2 Consultant Physician, Specialised COVID-19 Treatment Unit, Base Hospital, Teldeniya, Sri Lanka. 3 Consultant Radiologist, Specialised COVID-19 Treatment Unit, Base Hospital, Teldeniya, Sri Lanka. Clinical image descripton Silent hypoxia is a well-known entty associated with SARS- CoV-2 [1,2]. It is a conditon where despite the patent being hypoxic, they do not show any signs and symptoms of respira- tory distress [2]. Hypoxia can only be detected either by pulse oximetry reading or through blood gas analysis. These patents may have variable radiological appearances on presentaton. Many studies have shown silent hypoxia has a high incidence of 20-40% with patents with SARS-CoV-2 pneumonia [2,3]. Some patents need intensive care support and some recover without any supports. Here we present a series of chest radiographs of a patent presented with silent hypoxia. A previously well 53 year old male presented to a COVID-19 treatment facility with a positve antgen testng. At the tme of admission, the patent was well with a respiratory rate of 16/min and stable haemo- dynamics. There were no other signs and symptoms of respira- tory distress. His routne pulse oximetry reading was 66% with an arterial oxygen partal pressure of 56 mmHg. The frst chest radiograph showed an extensive air space opacifcaton (Figure 1). The appearance was so severe and did not match with his clinical picture. An entty of silent hypoxia was diagnosed, and he was admited to the Intensive care unit and started on face mask oxygen through 60% venturi. Figure 1: Chest radiograph on the day of presentaton with silent hypoxaemia showing extensive air space opacifcaton involving both lungs with more changes on the lef side Within the next 2 days, he deteriorated requiring non-invasive ventlaton.