This ongoing pandemic caused by the coronavirus or covid-19 is actually threatening the human population all throughout the world, especially the countries having limited health facilities and resources. Severe respiratory issues are one of the main features of covid-19 and for patient survival adequate ventilator support with enough oxygen is very much needed. But the main question which lies is, that if every corona positive patients are in need of Oxygen and why the oxygen is needed. Don't worry, all your dilemmas would be cleared from this article.
Reason behind the need for Oxygen for Corona Patients
The centres of Disease Control and Prevention estimate that around 3% to 17% of the patients affected with covid-19 develop a complication named as acute respiratory distress syndrome ARDS . These ARDS patients tend to lose their ability to breathe normally and it is also called respiratory failure which results due to the severe inflammation occurring in the lungs. This inflammation takes place when damage is done to the cells by the virus and for the positive patients the lungs get infected as the cells of the lungs develop the infection and in turn gets damaged. The inflammation also causes swelling which is a result of the increased movement of fluid to the site of the damage or injury. When this fluid comes inside the lungs, the lungs are unable to perform their normal function which is taking in oxygen and releasing the carbon dioxide.
More Indian patients are facing shortness of breath
The current data which is accumulated by the National Clinical Registry for covid-19 emphasises that a new and emerging Trend especially in the second wave is coming up with the shortness of breath to be the most common clinical features found in the hospitalized patients who are symptomatic. The ratio of breathing problems and need for oxygen among the hospitalized patients during the first wave and second wave is 41.7 % and 47.5% respectively. With the increase in shortness of breath there has been a decrease in some other symptoms like :
- Previously dry cough was 5.6 % and now it is 1.5 %
- Previously 7.7 % of the symptomatic patients lost their smell which has turned to 2.2 % right now
- Fatigue was noticed in 24.2 % of the patients which has reduced to 11.5 %
- During the second wave sore throat was observed in 16% of the First wave patients that has significantly dropped to 7.5 % currently
- Lastly, muscle ache was prevalent in 14.8% of the patients previously that has fallen down to 6.3 % currently.
Current need of oxygen in symptomatic patients
In India on 20 April, 2021 it was noticed that 1.75 % of the covid positive patients were in ICU beds, 0.40 % of the patients were kept in ventilators and 4.03 % of the covid-19 patients were occupying the oxygen beds. As the total number of active cases now have risen 2 20, 31 ,977 but the number of oxygen beds is limited so the need of patients requiring the oxygen beds is really significant. The members of the national covid-19 task force say that on 19th April, 2021 the hospital data shows that an important portion of the hospital admission which accounts for 54.5 % during the second wave are in need of some supplemental oxygen for their treatment procedure. There was an increase of 13.4% while compared to the first wave of coronavirus during the months of September and November. This data is being calculated after collecting the details of hospitalized patients from 40 centres all across the country.
As it has been said by Dr Balram Bhargava DG, Indian Council of Medical Research that still now there is some limited data as to why more number of patients are in need of oxygen and there is a need for more studies related to this. Even he also tried to throw some light on the sudden requirement of oxygen that as due to the sudden surge of cases in the second wave already a panic has been created and more number of positive patients are wanting to get admitted to the hospital. That is why, more number of patients are also requiring Oxygen and the oxygen requirement has suddenly risen up. He also said that due to the limited data gathered from the settings of the hospital, more research needs to be done. But oxygen is till now one of the significant tools required for managing the covid-19 disease mainly when there is a fall down of oxygen saturation. It has also been noticed that more number of men require oxygen support than women and the ratio is 23.5% versus 12.3% respectively. The reason is that more men are being affected by covid-19.
Situations requiring oxygen for clinical management of covid-19
As per the protocol of clinical management when a patient is suffering from the moderate complications of covid-19 symptoms then most probably he or she gets diagnosed with pneumonia but does not cause any symptoms of and severe disease. Along with the presence of the clinical features of the medical issue known as dipsomania which is the shortness of breath or hypoxia i.e., when the body is deprived of the adequate supply of oxygen in the tissue level. They might also have fever and cough and their oxygen saturation level may be less than 94 % as the range is between 90 to 94% in the room air.
Where as the moderate cases of covid patients needs oxygen therapy to be the primary form for the treatment process and the target remains to achieve a level of 92 to 96% of the oxygen saturation or 88 to 92 % of the saturation in oxygen level for the patient suffering from chronic and obstructive pulmonary disease. The main devices which are applied to administer the oxygen for moderate cases are masks with breathing or non rebreathing reservoirs, nasal prongs and some other instruments which depend on particular requirements. The protocol also promotes that awake pruning which is keeping the patients lie over their stomachs also acts as a rescue therapy for increasing oxygenation.
Three categories of severe cases which require oxygen in maximum level have been determined to be acute respiratory distress syndrome, sepsis and severe pneumonia. The protocol of clinical management also requires that the oxygen therapy should be at 5 litres per minute . While the respiratory distress of a patient is not being able to be evaluated after providing the standard oxygen therapy then a high therapy of nasal cannula oxygen or non invasive ventilation might be provided.
So, it is clear that not every patient suffering from coronavirus is in need of oxygen but you can keep a pulse oximeter handy. But instead of only relying on the pulse oximeter you can also monitor your muscle soreness, rate of fatigue and gastrointestinal symptoms. It is also always advisable to take medical help as soon as possible as you experience shortness of breath or respiratory uneasiness. As the prior you get diagnosed with covid-19, the better treatment can be provided to you.
Reference List:
https://www.path.org/articles/year-covid-19-medical-oxygen-scarcity-still-costing-lives/?gclid=CjwKCAjwmv-DBhAMEiwA7xYrdyoEf3POd8kCL-nrtCfInNr9lnJ_8ym-NOE77AUWRYicfGr_0GFRvxoCzskQAvD_BwE
https://indianexpress.com/article/explained/covid-19-second-wave-oxygen-shortage-7282246/
https://blogs.worldbank.org/health/oxygen-all-during-covid-19-coronavirus-and-beyond
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