Coronavirus: Breathing in distress, lung involvement in COVID? This is what doctors want you to know

Since the onset of coronavirus infection, we all know one thing with certainty that the virus affects lung health. And for that very reason, doctors are advising patients to start monitoring their oxygen levels with the help of an oximeter so that any abnormality can be caught and treated in time.

But when our breathing, which we all tend to take for granted, is affected, it is not an easy fight. And that’s exactly why most people start stocking oxygen cylinders, demanding admission to a hospital or panic that things will spiral out of control at any time. But Wait! With the right information in hand, you don’t have to do any of that!

In a recent interview, AIIMS Director Dr Randeep Guleria warns people not to panic. “Even if your oxygen saturation is 90 or higher, 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 is flattening on after your saturation becomes 90-92. ”

How to treat breathlessness at home

Dr SP Rai, Consultant, Pulmonary Medicine and Sleep Medicine, Kokilaben Dhirubhai Ambani Hospital recommends, first and foremost that one should not panic. Spo2 (oxygen) levels need to be monitored. The first 4-5 days there is usually no problem other than fever, cough, weakness of mild breathlessness. Monitor SpO2 level two or 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 and then re-monitor the spo2 levels. If it decreases by more than 4% then this means that lung involvement is significant (for example, before walking oxygen levels were 96 and after the walk, levels dropped to 90%, which means the lungs have not coped). If this happens then consult a doctor immediately.

If the spo2 reading continues to go between 90-95, do they still need to go to hospital?

If spo2 is between 90-95% it means COVID pneumonia is of moderate severity. In such cases, if the patient is already suffering from comorbidities such as diabetes, lung issues such as COPD, asthma, ILD or cardiac, kidney issues, specifically over the age group of 60, care must be taken. Depending on the severity and early signs of deterioration, the doctor will recommend going to hospital

If hospitalization is not recommended and the patient has no comparisons, the patient still has to be careful and continue to monitor 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 a prone position that is known to help improve lung oxygenation. Obese people will find it difficult to follow a prone position, so it is recommended to sleep on the right side and then switch positions to the left side every two hours to improve oxygenation. This method is especially recommended for people with spo2 between 90-95% or with even lower levels.

Patients suffering from obesity are also at higher risk of breathing difficulties, said Dr Jayalakshmi TK, Consultant, Pulmonology, Apollo Navi Hospitals Mumbai. “Obese people are more at risk for low oxygen levels and in addition they may have a condition called OSA or obstructive sleep apnea, so they may have more nocturnal disillusionment.”

What are the things that COVID patients can do to promote their lung health?

• Smoking and occupational exposure must be avoided

• Breathing exercises – pranayama, people can easily find simple home exercises on the internet. Balloon swelling or air pillows are also recommended

• Patients with chronic illness should be vaccinated against COVID, influenza 6 – 8 weeks after recovery.

• Appropriate COVID behavior, isolation, concealment and social distance are essential.

Any serious concerns that you notice among COVID patients with Lung Health?

Patients with comorbidities or at risk lung functions are at higher risk of catching COVID pneumonia and developing complications. Asthmatic patients should not stop taking inhalers. COVID pneumonia can also affect parts of the lungs or sometimes the whole lungs can be affected, adds Dr Jayalakshmi.

Patients with COPD or other lung problems should not skip their medications and keep track of their current disease

Follow breathing exercises, regular steam breathing is also safe.

Which comparisons make the lungs more vulnerable?

Lung-related diseases such as asthma, COPD, lung fibrosis, lung cancer, tuberculosis and other lung infections are dangerous with COVID as lung reserves may already be low. People with Diabetes, Hypertension, Cardiac, Renal Disease and Immunodeficiency Diseases.

Dr Jayalakshmi also stresses that low Spo2 readings may not indicate danger, or suffer from respiratory or pulmonary complications. “The lungs may be infected with COVID even if the saturation is around 97-98%. This is because the oxygen needs partial blood pressure to drop to 60 for ‘ saturation decreased to 90% In this part of the collapsing curve, the saturation BI is relatively maintained. About 50 percent of those with 97% saturation may have pulmonary involvement light. ”