In the lungs, COVID-19, at least initially, is a vascular insult, leading to overperfusion of affected zones resulting in low VA/Q situation. These changes lead to hypoxia, and consequently to compensatory hyperventilation. Since CO2 excretion is not affected due to its much higher solubility and to the linear characteristics of the CO2 dissociation curve, hypocapnia develops, to a point where the respiratory centers do not respond to hypoxia anymore, resulting in the condition of hypocapnic hypoxia without respiratory distress that was termed “Happy Hypoxia”. [...]
Mahjoub, Y., Rodenstein, D., & Jounieaux, V. (2023). Editorial: COVID-19 related acute vascular distress syndrome: from physiopathology to treatment. Frontiers in Medicine, 10, 1260309 [1-3]. https://doi.org/10.3389/fmed.2023.1260309 (Original work published 2023)