Importance Of Oxygen In Covid

If I were to come down with severe Covid-19 and choose to stay at home rather than go into hospital, would I benefit from receiving oxygen? Among the many questions surrounding palliative care at home, that’s the one that persistently nags at me.

There is good evidence that high-flow oxygen in hospital would improve my chances of survival but what about home-delivered oxygen? Does low-flow oxygen through a mask or nasal tubes, or a positive pressure ventilation machine (such as that which relieves breathing problems during sleep), make a difference to survival? I’ve not come across any case studies or random control trials of Covid care at home from any of the countries who were ahead of us as the pandemic developed. In countries with limited access to hospital care this will become an important issue.

And if I were to stay at home, would home-delivered oxygen help to make me more comfortable, even if it would not affect my survival chances? Which symptoms am I hoping it could control? Breathlessness certainly; but also confusion, delirium, anxiety?

Although various agencies have produced guidance about end of life care for Covid-19, some do not mention oxygen, some mention it in passing, and some say oxygen is not very helpful. It may be that high-flow oxygen in hospital relieves symptoms whereas low-flow oxygen at home doesn’t. If so, and if opiates are not sufficient on their own, then staying at home would deprive me of a comfortable death. If, on the other hand, it turns out that oxygen makes little difference to symptom relief, or that home-delivered oxygen is just as good and easily available, or that opiates are equally or more effective, then I could make the decision to stay in my own bed, confident that I won’t be risking putting myself and my loved ones through a distressing death by staying at home – at least as far as oxygen is concerned.