LTOT and Its Delivery

COVID-19 can lead to persistent hypoxia due to persistent inflammatory responses to SARS-CoV- 2 in the respiratory system. Post-COVID syndrome, may involve multiple organ systems leading to physical and medical sequelae following COVID-19, including chronic hypoxemia. Long-term oxygen therapy (LTOT) is an established treatment for patients with chronic hypoxemia, generally used in chronic airway diseases. Aims and objectives 1.To evaluate COVID-19 patients advised LTOT in post-COVID period 2. To determine if the need for oxygen support continues 3. To ascertain as to if these post covid patients actually need oxygen concentratorsMethodology500 post COVID-19 patients on oxygen therapy at home were questioned about LTOT at follow-up visit. Patients' demographics, admission symptoms, laboratory and radiological findings were recorded retrospectively from hospital database. Inclusion criteria1.patients aged 30 yrs and above2.Post covid patients patients with ARDS3.Patients consenting for the study Exclusion criteria Patients with active tuberculosis Patients with recent history of myocardial infarction in last 3 monthsResults1.There were 300 men (60%) and 200 women (40%) 2.The mean age of 68.6±12.6. 3.Average visit time for evaluation was 3.03±1.43 months. 4.18% of the patients died during the post-COVID process, which was related with high age (p=0.003), usage of mechanical ventilation (p=0.019) 5.The need for oxygen support continued in 32.9% of the patients. 6.Admission to intensive care unit and having a high serum D-dimer level (> 1000μg/L) were significant risk factors for the ongoing need of home oxygen support (p= 0.026 and 0.010, respectively). 7.The oxygen saturation level at hospital admission was found to be significantly lower in patients who continued to require oxygen therapy (p<0.001).Conclusion1.Most COVID-19 patients do not need LTOT in the post-COVID period meaning that the clinicians should be more selective when planning home oxygen therapy. Chest physiotheray and breathing exercises in post hospitalisation and pulmonary rehabilitation helped to exclude the need for LTOT in follow-up visits 2.Oxygen cylinders can be a more affordable option for most out covid patients discharged on LTOT. Oxygen concentrators should only be prescribed if home oxygen requirement persist on followup visits.