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COVID-19: What Is Happy Hypoxia? How To Detect It? Step By Step Process To Use Pulse Oximeter

Numerous studies have pointed out that the seemingly unusual phenomenon of happy hypoxia, or silent hypoxemia, in people with COVID-19 can be a serious symptom of the respiratory illness.

Initially reported in June 2020, happy hypoxia is reported in COVID-19 patients who appear seemingly fine. Patients suffering from happy hypoxia can walk and talk with ease. Their blood pressure, pulse readings also come in the normal range, even though their oxygen levels might have dipped well below 80 per cent in most cases [1].

What Is Happy Hypoxia?

Hypoxia refers to a condition when the oxygen level in the blood drops below the average mark, but the patient/person does not feel any symptoms. As a result, one does not get alarmed until the disease has progressed and there is severe damage to the lungs [2].

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Oxygen saturation for a healthy person remains above 94 per cent. It can be easily measured using an oximeter [3]. The normal oxygen saturation in the bloodstream of a healthy person is above 95 per cent, but COVID-19 patients display dangerous declines of less than 40 per cent.

Is Happy Hypoxia Common In Young People?

Reports also point out that happy hypoxia is becoming increasingly prevalent among youngsters. "Younger patients often experience happy hypoxia in which they do not feel any breathlessness or related symptoms till oxygen saturation levels fall below 80" [4].

Happy hypoxia is particularly seen in younger people because their immunity is high, because of which they can withstand some amount of hypoxia. They are comfortable even at 81 saturation levels, whereas in older people, symptoms appear at 92 saturation. In addition to this, young adults are also exposed to the virus more, as they are economically active [5].

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Is Happy Hypoxia Dangerous?

While hypoxia is a warning signal for imminent failure of vital body organs like the kidneys, brain, heart and is usually accompanied by prominent breathlessness, happy hypoxia does not prompt any such obvious external signs. As a result, in the initial stages of sickness, the COVID-19 patient, on the outside, appears to be alright and 'happy' [6].

Doctors assert that "this is a serious condition among Covid-19 patients. In my estimate, up to 30 per cent of COVID-19 patients needing hospitalisation have had happy hypoxia. In some cases of happy hypoxia, oxygen saturation had dropped to 20-30 per cent. This has been a major cause of deaths among COVID-19 patients in hospitals" [7].

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How To Identify Happy Hypoxia?

Doctors advise COVID-19 patients to check their oxygen levels using an oximeter regularly. Suppose the oxygen level drops below 90 per cent. In that case, immediate medical oxygen is required as oxygen starvation can impact vital organs severely [8].

Symptoms of happy hypoxia:

While cough, sore throat, fever and headache are common symptoms of COVID-19, the following are symptoms that should be closely observed for identifying happy hypoxia [9]:

  • change of the colour of lips from natural tone to blue,
  • skin discolouration to red or purple tone and
  • excessive sweating.

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How To Use Pulse Oximeter? Step-By-Step Guide

The pulse oximeter is a small, clip-like device that attaches to a body part, like toes or an earlobe. It is commonly put on a finger, and it is often used in a critical care setting like emergency rooms or hospitals.

The purpose of pulse oximetry is to check how well your heart is pumping oxygen through your body. It may be used to monitor the health of individuals with any condition that can affect blood oxygen levels - such as COVID-19, and other conditions such as the following [10]:

  • Chronic obstructive pulmonary disease (COPD)
  • Asthma
  • Pneumonia
  • Lung cancer
  • Anaemia
  • Heart attack or heart failure
  • Congenital heart defects

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A pulse oximeter reading is termed pulse oximetry, where the small clamp-like device is placed on a finger, earlobe, or toe. Then, small lights you will see pass through the blood in the finger, measuring the amount of oxygen. The pulse oximeter will help show the oxygen saturation levels along with your heart rate.

Step 1: Remove any nail polish or nail decorations and warm your hand if cold.

Step 2: Rest for at least 5 minutes before taking the reading.

Step 3: Rest your hand on your chest at heart level & hold it still.

Step 4: Switch on the oximeter and place it on your middle or index finger.

Step 5: The reading takes time to steady, so keep the oximeter steady and in place, for at least a minute or longer if the reading is not stable.

Step 6: Record the highest result once it has not changed for 5 seconds.

Step 7: Identify each reading carefully.

Step 8: Record the reading three times a day at the same time.

On A Final Note...

Doctors advise proning for home-isolation patients as an immediate remedy. However, if the oxygen level drops below 90 per cent, immediate hospitalisation is required as the patient may need medical oxygen supplement or ventilator support.

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