The second Covid wave has infected the younger population of the country, unlike the first outbreak. Many youngsters are reporting lung infections and “Happy Hypoxia”, a condition where the patient has low oxygen saturation but does not feel any symptoms of low saturation. As a result, they do not get alarmed until the disease has progressed and there is severe damage to the lungs.
According to medical experts, non-regular monitoring of oxygen saturation levels in these cases could cause death also as the drop could be too steep and youngsters would not realize because of their high immunity and health.
The normal oxygen saturation in the bloodstream of a healthy person is above 95 percent, but these cases could display a dangerous decline of as little as 40% and would need immediate oxygen support and in critical cases, ventilators as well.
Younger patients often experience ‘happy hypoxia’ in which they do not feel any breathlessness or related symptoms till oxygen saturation levels fall below 80. Usually, symptoms like breathlessness and discomfort in the chest are experienced when oxygen levels fall below 90 saturation. But in cases of happy hypoxia patients get alarmed late.
Explaining, Dr. Kiran Madala, in-charge, head of the department of critical care, Nizamabad Medical College, said, “The phenomenon is particularly seen in younger people because their immunity is high, because of which they can withstand some amount of hypoxia. They are comfortable even at 81 saturation level, whereas in older people symptoms appear at 92 saturation. This is a reason for late admissions.”
The fact that more younger patients are getting affected and seek medical help late also means more deaths among youngsters. Doctors are now suggesting ‘alerts on symptoms’ at various stages of the disease.
“Covid can be mild in 85%, moderate in 15%, and 2% cases can be fatal. Alert signs are needed for the patients going from mild to moderate to critical. The government should form a scientific committee of doctors from government and private hospitals to issue detailed daily alerts of symptoms to look out for to the public.
Dr. Kapil Zirpe, a member of the city and district Covid-19 task force and head of department, critical care at Ruby Hall Clinic, said that patients with mild and severe symptoms show “Happy Hypoxia”. “Some patients who are at home also display drastic drop of oxygen levels which is common in this condition,” said Dr. Zirpe.
Dr. Dnyaneshwar Mote, a member of the Pune city Covid task force for Social Action, said that at least 10 percent of patients showing “Happy Hypoxia” will need critical care. “This condition is seen in patients with mild symptoms or who are asymptomatic. They may not show symptoms of breathlessness but their SPO2 (blood oxygen saturation) levels are dangerously low. This can worsen the Covid symptoms and damage lungs severely,” said Dr. Mote.
He said patients should regularly monitor the oxygen levels in the blood. “If they notice a drop in oxygen, they must contact their physician immediately and arrange for a bed before symptoms get worse. Patients who are treated in time can recover fast without much lung damage in Covid,” said Dr. Mote.
Goa Medical College (GMC) head of Pulmonary Medicine Dr. Durga Lawande said that the oxygen levels on the pulse Oximeter of those under home isolation must be continuously checked. A six-hour gap between oximeter checks should be ideal.
When and if the O2 level drops below 95%, it is time to see a doctor immediately or get admitted to a hospital so that doctors take over from thereon. Doctors may advise a CT scan of the chest to know if there is lung involvement and if yes, then to what degree.
Those whose O2 levels seem normal (at least 95%), but have been affected by COVID-19 must do the 6-minute-walk-test or the 6MWT to ensure that their general feeling of normal O2 levels is not a case of Hypoxia. Patients isolating at home (with oxygen level at 95% min) should do the simple 6-minute walk test (6MWT) to look for inducible hypoxia and to check their true Oxygen level.
For this, a patient needs to first monitor their oxygen level, then take a walk inside the room for six minutes and again check their oxygen saturation. If the O2 level falls to 92%, take that as an alarm signal.
The six-minute walk test is a measure of functional status or fitness, a simple measure of aerobic exercise capacity. During this test, you walk at your normal pace for six minutes. This test can be used to monitor your response to treatments for heart, lung, and other health problems. For a patient who looks comfortable and is not hypoxic at rest, the 6MWT helps in the early detection of hypoxia and initiating early higher-level care. The 6MWT also helps in looking for discharge preparedness of patients.