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Does Home Pulse Ox Keep COVID-19 Patients Out of Trouble?

May 10, 2022

Written by Lillian Harry

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For patients with COVID-19 enrolled in an at-home monitoring program, utilization of home pulse oximetry did not result in mortality benefit and days out of the hospital in comparison to subjective assessments of dyspnea.

Why does this matter?
Home monitoring systems became popular during the COVID-19 pandemic to manage patients at home and decrease surges of patients presenting to the ED. Does the addition of at-home pulse oximetry improve the clinical outcome for patients with COVID-19?

Can’t put a finger on it
Design: COVID Watch was implemented by the University of Pennsylvania Health System (UPHS) to support patients with COVID-19 who didn’t meet inpatient criteria. After being diagnosed with COVID- 19, patients were randomly assigned to participate in the standard monitoring program or standard monitoring plus home pulse oximetry. Patients received daily text messages to assess for dyspnea for 14 days. The patient’s response to the text message would determine if they needed escalation of care.

Results: Pulse oximetry at home did not affect the clinical outcome of patients when compared to subjective assessments of dyspnea alone. There was no significant difference between the groups in the number of days they were alive and out of the hospital at 30 days post diagnosis

Implications: It is important to recognize the innovative system at UPHS. The text message follow-up is a novel break from relying on telemedicine or other modalities which may isolate subsets of patients. Home monitoring systems will be an expanding frontier as technology pushes medical care away from healthcare settings.

Limitations: For ethical reasons, patients could not be assigned to a control “no monitoring” group.

Peer reviewed by Drs. Kristina Domanski and Ketan Patel

Pulse Oximetry for Monitoring Patients with Covid-19 at Home – A Pragmatic, Randomized Trial. 2022 Apr 6. N Engl J Med. 2022;NEJMc2201541. doi:10.1056/NEJMc2201541. Online ahead of print.

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