By Apollo 24/7, Published on - 23 April 2021
The human body requires oxygen to survive and to carry out various vital functions. The respiratory system works along with the circulatory system to provide oxygen to the body. When oxygen is inhaled, it goes to the lungs and then moves into the blood vessels and mixes with the blood. This oxygen-rich blood is then circulated in the cells and tissues of the body.
However, due to inflammation and infection in the lungs, some people suffering from severe COVID-19 infection develop hypoxemia (low oxygen levels in the blood). These patients require medical oxygen to restore the oxygen saturation of the body.
Medical oxygen is a highly pure form of oxygen that is used to improve the oxygen levels in people suffering from critical conditions such as chronic obstructive pulmonary disease (COPD), cardiac or respiratory arrest, shock, cyanosis, and severe hemorrhage. Medical oxygen is either provided through a vacuum insulated evaporator (used to store liquid oxygen), oxygen cylinder, or oxygen concentrator (separates oxygen from the atmospheric air).
The novel Coronavirus, SARS-CoV-2, binds with the ACE-2 receptors present in the lungs. The virus infects the epithelial cells that line the respiratory tract and protect the airway tract from pathogens and infections. Once they get infected, a series of changes occur in the body:
All these factors can make it difficult for the patient to breathe normally, and they end up requiring oxygen therapy.
All COVID-19 positive patients do not require oxygen supplementation. The signs of oxygen distress that could be seen in COVID-positive patients include:
Not all COVID-infected patients show signs of oxygen distress. Various case studies have reported incidences of happy hypoxia or silent hypoxia in COVID-infected patients. In silent hypoxia, the infected patients have extremely low blood oxygen levels, but they do not develop breathlessness or any other symptoms of oxygen distress. This has been one of the major reasons for pulmonary thromboembolism and sudden cardiac arrest. Silent hypoxia may accompany other symptoms such as muscular pain, fatigue, fever, and cough.
If a COVID-positive person does not show any symptoms of hypoxia or if the doctors need to determine the oxygen levels of the patient, some tests that may help determine the need for oxygen supplementation include:
It is a well-known fact that viruses continuously mutate (change) over time. While sometimes the new variants are weaker than the original virus, at other times, the variant gets stronger, allowing it to multiply faster and cause more infection.
India is currently suffering from a new variant of SARS-CoV-2, called B.1.617. Two mutations of this variant, E484Q, and L452R, have been found in India. Scientists and the health ministry of India have stated that this double mutant variant of the COVID-19 virus is more virulent. This new variant affects the lungs even more, resulting in increased demand for oxygen therapy.
Oxygen requirement has been reported in patients suffering from severe COVID-19 infection, which resulted in severe pneumonia, acute respiratory distress syndrome, or sepsis. As per the ICMR guidelines released on 21.April.2021, people with moderate symptoms may require oxygen support via a non-rebreathing face mask to achieve the target SpO2 levels between 92% to 96%. On the other hand, severe cases may need NIV (Non-Invasive Ventilation) or HFNC (High flow nasal cannula) respiratory support to stabilize SpO2 levels.
Due to the unprecedented increase in the number of COVID-19 cases during the second wave, there is a surge in the demand for medical oxygen and antiviral drugs for the treatment of infected people. Doctors are requesting people to follow COVID-19 prevention norms such as staying indoors, wearing masks, and maintaining physical distance, to reduce the pressure on healthcare infrastructure and resources.
People must register themselves for COVID-19 vaccination, as studies have shown that vaccinated people are less likely to get severe symptoms of COVID-19. From 1st May 2021, people aged 18 or above can get vaccinated.
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