It causes hypoxia by killing red blood cells, releasing highly oxidative cell-free haem into the blood stream which prompts the body to reduce oxygen saturation as a protective measure, hence the victims get out of breath easily but as it is not the lungs that are primarily affected it is not respiratory as such.  If the condition is sustained oxidative damage will be done to the lungs though, as well as all around the body.  This is amplified if the person is given oxygen therapy, especially vi
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