Patients with coronavirus disease 2019 (COVID-19) seldom complain of dyspnea. It has been suggested that the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) targets the brainstem and plays a role COVID-19 respiratory failure. We hypothesise that asymptomatic hypoxemia presented by COVID-19 patients with severe pneumonia is related to a dysfunction of cortical rather than of subcortical structures, and is linked to SARS-CoV-2 neuroinvasiveness. This article is protected by copyright. All rights reserved.