Oxygen Therapy and Associated Risk Factors for Home Isolated COVID-19 Patients: A Review

Abstract

During the second wave of the viral pandemic, hospitals were overcrowded by the escalation of Coronavirus Disease-2019 (COVID19) cases. To effectively address the drastic escalation of the COVID-19 pandemic, innovative solutions are warranted. The rising demand for critical-care services burdens hospitals; hence, to alleviate the burden on the healthcare system, asymptomatic patients or those with mild symptoms can be treated at home through continuous monitoring and care. Affected patients are at risk of hypoxia, which urgently requires oxygen therapy. Depending on the extent of oxygen demand, patients can boost their oxygen levels by making use of a nasal cannula, face mask, oxygen cylinder, and/or oxygen concentrator. Several risk factors are associated with the augmented probability of COVID-19 progression to severe status due to increased oxygen requirement, and they include advanced age, obesity, glucose intolerance, hypertension, and cardiovascular disease. A close monitoring of oxygen saturation (SpO2 ) along with other clinical investigations like complete and differential blood counts, serum electrolytes, random blood sugar, liver function tests, coagulation profile (Prothrombin Time (PT), activated Partial Thromboplastin Time (aPTT) and International Normalized Ratio (INR)), renal function test, C-reactive protein (CRP), D-dimer and ferritin level are mandatory for patients receiving home-based oxygen therapy. An awareness of safety considerations such as perfectly fitting, proper sized mask, availability of ventilation, knowledge of caregiver about danger signs and good functioning of fire alarm system at home are of prime importance before setting up oxygenation devices at home, and this further mandates a comprehensive evaluation of home-based management and treatment of mildly symptomatic patients with COVID-19.