But when our breathing, which we all tend to take for granted, gets impacted, it isn’t an easy battle. And that’s the very reason that most people start stocking oxygen cylinders, insist on getting admitted to a hospital or panic that things will anytime spiral out of control. But Wait! With the right information in hand, you do not have to do any of that!
In a recent interview, AIIMS Director Dr Randeep Guleria warns people to not panic. “Even if your oxygen saturation is 90 and above, you don’t have to take it to 98-99. If you manage to bring it to 92-93, that’s good enough because what we know from physiology is that what we call the oxygen disassociation curve flattens out after your saturation becomes 90-92.”
How to handle breathlessness at home
Dr S.P Rai, Consultant, Pulmonary Medicine and Sleep Medicine, Kokilaben Dhirubhai Ambani Hospital recommends, first and for most one should not panic. One needs to monitor the spo2 (oxygen) levels. The first 4-5 days usually there is no problem other than fever, cough, weakness mild breathlessness. Monitor SpO2 level two-three times a day. If SpO2 levels drop below 95%, it indicates mild to moderate pneumonia. One should monitor the spo2 levels at rest and then take a six-minute walk followed by re-monitoring the spo2 levels. If it drops more than 4% then this means the lung involvement is significant (for e.g. If before walking the oxygen levels was 96 and after the walk, the levels dropped to 90%, which means the lung has not coped up). If this happens then immediately consult a doctor.
If the spo2 reading keeps going from 90-95, do they still need to get hospitalized?
If spo2 is between 90-95% it means the COVID pneumonia is of moderate severity. In such cases, if the patient is already suffering comorbidities like diabetes, lung issues like COPD, asthma, ILD or cardiac, kidney issues, specifically over the age group of 60, being cautious is a must. Depending on the severity and early signs of deterioration, hospitalisation will be recommended by the doctor
If no hospitalisation is recommended and if the patient has no comorbidities, the patient still has to be cautious and continue to monitor the spo2 levels.
Does lying on the stomach help the lungs? Anything that obese people should be careful about?
Lying on the stomach or upside down is called prone position which is known to help in improving oxygenation of the lungs. Obese people will find it difficult to follow prone positioning, hence it is recommended to sleep on the right-hand side followed by changing positions to the left-hand side every two hours to improve oxygenation. This approach is recommended especially for people with spo2 between 90-95% or with levels even below that.
Patients suffering from obesity are also at a higher risk of facing breathing difficulties, Dr Jayalakshmi TK, Consultant, Pulmonology, Apollo Hospitals Navi Mumbai says. “Obese people are at higher risk for low oxygen levels and additionally they may have a condition called OSA or obstructive sleep apnea hence may have more of nocturnal desaturation.”
What are the things that COVID patients can do to boost their lung health?
• Smoking and exposure to occupational has to be avoided at all cost
• Breathing exercises – pranayama, people can easily find simple home exercises on the internet. Inflating a balloon or air pillows is also recommended
• Patients with chronic illness should get vaccinated against COVID, flu 6 – 8 weeks after they recover.
• COVID appropriate behaviour, isolation, masking and social distancing is a must.
Any serious concerns that you are noticing among COVID patients with lung Health?
Patients with comorbidities or compromised lung functions are at a higher risk of contracting COVID pneumonia and developing complications. Asthmatic patients should not stop taking inhalers. COVID pneumonia can also affect parts of the lung or sometimes the whole lung can be affected, adds Dr Jayalakshmi.
Patients with COPD or other lung issues should not skip their medications and keep their existing disease under check
Follow breathing exercises, regular steam inhalation is also safe.
What comorbidities make lungs more vulnerable?
Lung related diseases like asthma, COPD, lung fibrosis, lung cancer, tuberculosis and other lung infections are risky with COVID since lung reserves could already be low. People suffering from Diabetes, Hypertension, Cardiac, Renal disease and diseases with decreased immunity.
Dr Jayalakshmi also emphasizes that low Spo2 readings may not be the sign of danger, or suffering from respiratory or pulmonary complications, “It is possible that lungs are infected with COVID even if the saturation is around 97-98%. This is because the oxygen partial pressure in the blood needs to drop to 60 for the saturation to fall to 90%.In this part of the falling curve, the saturation BI’s relatively maintained. Around 50 per cent of those with saturation 97% may have mild lung involvement.”