Covid’s ‘happy hypoxia’ taking toll on youngsters

Nagpur: City doctors have red flagged ‘happy (or silent) hypoxia’ condition which may be resulting in higher toll of youngsters from Covid. That Covid causes hypoxia, or fall in oxygen saturation in blood is well known. Usually, it results in breathlessness or drowsiness. Happy hypoxia refers to condition in which blood oxygen saturation goes down but there are no symptoms that might alert the patient.
Youngsters, with better tolerance levels, may be more prone to this, said doctors adding that this often resulted in them seeking treatment late which on occasions proved fatal. They appealed to everyone, especially youngsters, to frequently check SpO2 levels and get hospitalized if it goes below 92% and also get ready for a HRCT scan.
Senior physician Dr Jay Deshmukh of Sunflower Hospital said the happy hypoxia victims many times did not feel breathless even at 80-84% saturation. “There are almost nil symptoms but they deteriorate fast requiring doctors to remain extremely vigilant. I have witnessed around half a dozen patients below 40 years of age sinking after suffering happy hypoxia at home and reporting late to hospital,” he said.
Supported by studies of the substantial cases of prolonged hospitalizations and also deaths among youngsters as published by TOI earlier, the experts claimed the ‘happy hypoxia’ did not allow the progression of Covid to come to fore until much later by when it turns into a complicated case and is on verge of slipping out.
No discomfort and a low score on HRCT scan has misguided many to believe there is nothing wrong with them, said Dr Anup Marar, convenor of the Vidarbha Hospital Association.
“The lungs’ reserve oxygen is nearly over as soon as one reaches 84-85% saturation. Then, the body starts crumbling under it’s need. By the time the hospitalization takes place, the saturation is hovering in the range of 70-75%. The damage is enormous now,” said senior physician Dr Nikhil Balankhe of Viveka Multispecialty Hospital.
“If one’s oxygen saturation is below 92%, then rush to report to a doctor or get hospitalized and get the HRCT scan done immediately,” he said. “A young person under my supervision had 96% saturation and a zero score in HRCT initially. I asked him to get HRCT done again as his saturation sank to 90% but he had refused stating he was felling healthy. Within three days, his severity score went to 9,” said Dr Balankhe.
Dr Rajesh Atal, senior physician associated with Orange City Hospital, said younger people tolerate oxygen depletion well and underestimate it which leads to peril. “We need to have good quality of pulse oximeter handy and keep checking oxygen level frequently. I have treated a patient who had no major complaints even at 69% saturation but his HRCT score was an alarming 16. We had to ramp up the treatment with Remdesivir, oxygen therapy and other medications to salvage the situation. He took a long time to recover,” said Atal.
Dr Marar stated youngsters were told during the first wave that they were the least vulnerable but the situation has witnessed a sea change now as they were also unvaccinated in the peak of the second wave caused by a variant. “It takes no time for HRCT score to race past 15 with a saturation of 80% for youngsters feeling hale and hearty. There is no scope of over-confidence even when there is no co-morbid condition. Don’t allow that four-five days of delay making it more complicated,” he said.
Dr Mahesh Fulwani of Shrikrishna Hospital said there was no parameter to foretell which happy hypoxia victim would deteriorate. “It’s difficult to gauge the reason but could be the virus variant too,” he said.
Renowned physician Dr Rajan Barokar of Kingsway Hospital said ‘happy hypoxia’ patients were coming with 90-92% saturation and a HRCT score of 15-20. “We are currently treating a few young patients in our ICU. Situation is scary,” he said.