I originally posted this review (and goofy video) on Steam, but I figured I'd share it here for anyone else interested.
Lost in Vivo is yet another 90s retro horror game in the current wave of similar titles - but I wouldn't group it in with all the rest. It doesn't have excessive VHS or noise filters just to obscure some poor low-poly graphics. Things actually look decent for the self-imposed graphical limitations. It's a strange mix of low-poly and some pixel art textures along with a few modern effects like Bloom.
The game plays much like the old Silent Hill/Resident Evil titles where you have linear sections, semi-open puzzle sections, and plenty of weird cutscenes and creepy stuff happening in-between. This game also adds quite a bit of fourth-wall breaking and "alternative" gameplay styles at certain points. Not to spoil anything: some of these work well and add a unique touch, while others are predictable, having been done many times before.
The bulk of the game you'll be walking down slightly-too-long corridor sections, exploring some minor branching paths, fighting numerous creepy enemies, and generally just experiencing some spooky ambiance. The music and sounds work quite well, setting a foreboding tone. There could definitely be more sound effects to add more life to the world, but for what it is, the current audio does the job well.
The combat, like many other reviewers stated, somewhat devolves in to an action experience after a while. Although I don't think it ruins the gameplay like some might suggest. The enemy AI is a little boring in general, mainly just walking directly in to you and clipping your body, but the weapons all feel nice to use. Acquiring different tools and collecting ammo was a nice addition. However, since there are no healing items, you either need to die or stand around (possibly for minutes at a time) to regain health. I always opted for a quick death in those situations, which does detract from the horror.
All that aside, the game is quite buggy. Just off the top of my head: pressing the attack button while running does nothing but stop you from running, switching weapons with the number keys doesn't work about 50% of the time, reloads glitch out with the other animations giving you instant or non-reloads occasionally, almost every enemy clips in to your body, you can get stuck in the geometry (thankfully I was always able to get out), and enemies can also get stuck in the geometry. Worst of all: there are major sequence/save breaks that I see a few others have experienced. Thankfully I never ran in to those, as I wouldn't have the heart to start the entire ~3-4 hour game from scratch.
Overall it's definitely a weird and creepy experience, which is why I'm recommending it. I think you'll be pleasantly surprised at least once or twice with some novel sections. That and the monster/audio design is actually very unique. It's a game to play once and be happy you experienced it.