At-home monitoring of blood oxygen levels is a safe way for people with COVID to see if their condition is deteriorating, putting them in need emergency and hospital care, according to new research.
Pulse oximeters are readily available, relatively inexpensive devices. Studies have shown that a drop in blood oxygen levels is a critical indicator that a COVID patient’s health is deteriorating.
The study, published in Lancet Digital Health, carried out the first extensive evidence review of pulse oximetry and its potential in home monitoring for people with COVID.
Thirteen studies involving almost 3000 participants across five countries, were analysed, most of which were carried out during the first pandemic wave.
The investigators found that home oxygen monitoring, with medical guidance, was a safe and effective ‘safety net’ for who were ill with COVID at home, picking up early signs of deterioration and escalating care where necessary, thereby reducing the burden on strained clinical resources.
There was however a note of caution due to the lack of research on darker-skinned patients, in whom oximetry may be less accurate than in lighter-skinned people.
The researchers proposed some key recommendations to help standardise the practice of at-home oximetry for COVID monitoring.
The study makes the recommendation the use of a defined cutoff point in blood oxygen levels (92%), which will enable healthcare professionals to determine when a patient needs to go to hospital for treatment, or whether they can rule out the need for further care at the time.
Dr Ahmed Alboksmaty, Research Associate from the Institute of Global Health Innovation, said: “Throughout the pandemic, concern among the public has shifted from ‘Have I got COVID?’ to ‘If I got COVID, do I need to go to hospital?’. Our study shows that people with COVID can safely keep an eye on their blood oxygen levels at home using pulse oximetry. If their oxygen levels drop below a certain point, then this indicates that they need to seek professional medical care.
“Pulse oximetry is easy to self-use, affordable in cost, widely available, and as we have shown, a useful way to identify health deterioration in COVID patients.”
Some smartphones and mobile apps can also measure blood oxygen levels, which the researchers identify as a potentially widely accessible monitoring tool. However, though some studies have shown similar accuracies to conventional oximeters, the researchers say there is not enough evidence to support their use.
Current knowledge gaps also included insufficient data on whether pulse oximetry can improve the health outlook for patients.
Dr Ana Luisa Neves, Advanced Research Fellow from the Institute of Global Health Innovation, said: “Our research has demonstrated how the use of pulse oximetry in remote patient monitoring could help ease the strains on health systems during the COVID pandemic. However, it’s vital to ensure that the current lack of research in racially and ethnically diverse populations is addressed. It’s therefore critical to provide support to ensure this technology reduces, rather than entrenches, existing health inequalities.”
Source: Imperial College London
