Got Covid? Signs That You May Have ‘Happy Hypoxia’ & When to Rush to the Hospital

This article is a part of a series by The Better India to share verified information about COVID-19 care. While several posts on various aspects of fighting COVID-19 are being circulated on social media and messaging services like WhatsApp, we urge you not to trust unverified content. To separate fact from fiction, we will be sharing the videos and content with doctors and experts and bring you their responses with scientific research-backed information.

In patients who have tested positive for COVID-19, one of the parameters that doctors ask you to check consistently is your oxygen saturation level. Caution is advised in case the oxygen saturation level drops below 95 per cent.

Dr Randeep Guleria, Director, All India Institute of Medical Sciences (AIIMS) in a press conference said, “Oxygen saturation of 92 or 93 in COVID-19 patients should not be considered critical; instead, this level is only a buffer that enables the patient to reach hospital on time.”

However, what if the oxygen saturation levels in a patient drops without exhibiting any warning signs or symptoms? This condition is referred to as Happy Hypoxia.

Dr Ravi Shekhar Jha, Head of Department and Senior Consultant, Pulmonology, Fortis Escorts Hospital, Faridabad, and Dr Vineet Malhotra, Clinical Director – Urology, Andrology and Male Health Specialist at Diyos Hospital, Delhi, help us understand this phenomenon better.

1. What is happy hypoxia?

Dr Jha: Hypoxia can be explained as a phenomenon in which one experiences low oxygen saturation levels. Usually, patients who experience hypoxia feel breathless. However, in some patients with COVID-19, we are seeing no breathless symptoms and that delays treatment. This feeling of not being breathless and yet having low oxygen saturation levels is what is termed as ‘happy hypoxia’.

Dr Malhotra: Since no symptom presents itself, patients do not get alarmed and that leads to the disease progressing and causing severe lung damage.

2. Since happy hypoxia does not present itself with any symptom, how can one detect this early on?

Dr Jha: Happy hypoxia in itself means there are no symptoms that can help detect it. Patients remain asymptomatic and the only way to keep a track is to regularly check the oxygen saturation level in COVID-19 patients. Some patients do complain of dizziness or fainting while walking, but by and large there are no telling signs.

Dr Malhotra: As soon as the oxygen saturation level dips, the patient will start to crash. This might be accompanied by discoloration of lips and skin, profuse sweating and even severe headache.

3. Are there cases of happy hypoxia impacting some more than others?

Dr Malhotra: This is seen more in young adults, who have higher immunity and are able to withstand some amount of hypoxia. These patients are usually comfortable even when their oxygen saturation level hits 80.

This is one of the reasons why they get admitted late and therefore experience a delay in treatment.

4. What oxygen saturation level should one watch out for? When does it warrant hospitalisation?

Dr Jha: Anyone experiencing an oxygen saturation level of less than 92 must be taken to a hospital immediately. If the patient is elderly and suffers from diabetes, in such a condition even a reading of 94 warrants hospitalisation.

While at rest keep checking oxygen saturation levels, if you are COVID-19 positive. It is also advisable to try the 6-minute walk test. Walk around for 6-minutes and then check your saturation levels. If there is a significant drop, for example, if the reading goes from 95 per cent to around 88-89 per cent, then you must get to the hospital immediately.
Dr Malhotra: If COVID-19 positive, maintain a log and check oxygen saturation level every two hours. In case the oxygen saturation falls below 94 per cent, one should seek immediate medical advice. If saturation falls below 90 per cent, one should seek hospital admission.

Always consult your doctor if you have any discomfort and do not self-diagnose.

(Edited by Yoshita Rao)

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