Some people infected with SARS-CoV-2 develop a syndrome known as COVID-19, including viral sepsis, pneumonia, and hypoxemic respiratory failure. Due to the situation’s urgency, scientific validation of early observations and proclamations on COVID-19 was not possible in the first few months of the pandemic because of the unique disease presentation, massive surges of critically ill individuals, and severity of illness. The condition known as “happy hypoxia” is one example. It was widely reported in the popular media due to the widespread belief that the absence of respiratory distress and dyspnea in the face of severe hypoxemia represented a novel and puzzling phenomenon. In the presence of hypoxemia, a lack of outward signs of distress is referred to as silent hypoxemia. On the other hand, respiratory physiologists have a name for this phenomenon: hypoxic ventilatory decline. The physiological systems that regulate breathing, breathing perception, and cardiovascular correction explain silent hypoxemia. This narrative review looks at the possible role of viral infection of the central and peripheral nervous system in causing silent hypoxemia during COVID-19. Furthermore, clinicians’ naive acceptance of joyful hypoxia and the novel hypotheses presented to explain it have shown substantial misconceptions of the physiologic systems underlying the control of breathing and the modification of respiratory feelings. As a result, this paper’s primary objective is to analyze these themes comprehensively.