Use of home pulse oximetry to enhance remote COVID-19 monitoring: Evaluating a single centre experience

Abstract

Introduction Telehealth and remote monitoring of patients with mild COVID19 infection have developed rapidly in response to the pandemic. Many healthcare systems have embraced telehealth for remote clinical monitoring and pulse oximetry for enhanced monitoring. Methods The experience of a large healthcare centre's COVID Virtual Ward was reviewed retrospectively with a particular focus on evaluating the effectiveness, safety and utility of finger pulse oximetry within the home. Data from a 2 month period in early 2022 during a BA1 Omicron wave was retrospectively reviewed. 551 high risk patients were issued with pulse oximeters for monitoring oxygen saturations within their home. All patients received daily clinical review via telephone by a nurse or doctor. The group was highly vaccinated with only 6.4 percent of the cohort unvaccinated. Oximeters were promptly delivered via courier service across a vast geographical area. Results Pulse oximetry was well utilised by almost all patients. Only 2.7 percent of the cohort demonstrated resting oxygen saturations of less than 94 percent during their Virtual Ward admission. 91 percent of patients reporting dyspnoea were able to be safely managed without escalation to an emergency department due to reassuring clinical and oximetry assessment. Home oxygen saturations correlated well with saturations recorded within the ED, with no patients found to have lower saturations compared with home saturations. Discussion Within a high risk population experiencing COVID19 infection, pulse oximetry was a useful tool in clinical assessment, correlated well with hospital based pulse oximetry and allowed a substantial reduction in COVID19 related ED presentations.