Are Home Pulse Oximeters Useful for COVID Recovery?
2022-07-18
By Fran Kritz
How Pulse Oximeters Work
Pulse oximeters use infrared light refraction to measure how well oxygen is binding to your red blood cells. If your blood oxygen level (called oxygen saturation) is too low, it can make it hard for your body to work properly and can put a strain on vital organs like your lungs and brain.
According to the Cleveland Clinic, a normal pulse oximeter reading is between 95% and 100%. The devices have a digital display that flashes the reading. If you have a lung disease such as COPD or asthma, your normal oxygen saturation level may be lower.
Research on the Value of Pulse Oximeters for COVID-19 Is Mixed
Hospital grade pulse oximeters, which have to be approved by the FDA, have been on the market for about four decades. Nonprescription home versions—which are not reviewed by the FDA—came on the market about twenty years ago.
Studies vary on the value of home pulse oximeters for helping patients with COVID-19. For example, a study by researchers at the University of Pennsylvania found that using a pulse oximeter to measure oxygen levels is no better than just regularly asking patients with COVID-19 if they are short of breath.
But the study had a key limitation: All of the enrolled patients had immediate access to health care providers they could contact if they noticed changes in their symptoms or their pulse oximeter readings. A news release notes that for people with COVID-19 who don’t have such immediate access, “self-monitoring with pulse oximeters may still be a reasonable approach until there is evidence to the contrary.”
Similarly, a review of 13 studies that included 2,900 people concluded home pulse oximeters are “pulse oximetry is potentially an effective tool for monitoring deterioration and keeping patients safe at home.” However, further research “should involve more diverse populations, test the system in resource-limited settings, and assess the effect on health outcomes compared with other systems.”
UPenn study co-author Anna Morgan, MD told Verywell that she sees no harm in having a pulse oximeter.
“But if you are otherwise healthy and don’t have one and contract COVID, not having the device is not a reason to panic,” Morgan said. “We learned that the symptom of shortness of breath is telling.”
Who Are Pulse Oximeters Best Suited For?
Before the pandemic, home oximeters were most commonly recommended by doctors to help patients monitor health conditions such as chronic lung disease, shortness of breath, or heart disease, Jonathan Parsons, MD, a pulmonologist at the Ohio State University Wexner Medical Center, told Verywell.
Morgan added pulse oximetry is valuable for COVID-19 patients with underlying lung disease, as well as people who have speech or cognitive difficulties and may not be able to communicate about worsening symptoms.
Who Should Not Use a Pulse Oximeter?
One key limitation of pulse oximeters, which the FDA will be investigating, is that they may not be accurate in people of color.
A January 2021 study by researchers at the University of Michigan found that Black patients were almost three times as likely as White patients to have low oxygen levels that were missed by pulse oximeters.The researchers said that could translate into as many as 1 in 10 inaccurate readings among Black patients and prompted the February 2021 FDA advisory.
The FDA notes that because pulse oximeters use light that passes through the skin to measure oxygen levels, anything that interferes with the light, like a darker skin tone or even nail polish, can cause inaccuracies.
Parsons said that cold hands can also impair readings.
How Pulse Oximeters Work
Pulse oximeters use infrared light refraction to measure how well oxygen is binding to your red blood cells. If your blood oxygen level (called oxygen saturation) is too low, it can make it hard for your body to work properly and can put a strain on vital organs like your lungs and brain.
According to the Cleveland Clinic, a normal pulse oximeter reading is between 95% and 100%. The devices have a digital display that flashes the reading. If you have a lung disease such as COPD or asthma, your normal oxygen saturation level may be lower.
Research on the Value of Pulse Oximeters for COVID-19 Is Mixed
Hospital grade pulse oximeters, which have to be approved by the FDA, have been on the market for about four decades. Nonprescription home versions—which are not reviewed by the FDA—came on the market about twenty years ago.
Studies vary on the value of home pulse oximeters for helping patients with COVID-19. For example, a study by researchers at the University of Pennsylvania found that using a pulse oximeter to measure oxygen levels is no better than just regularly asking patients with COVID-19 if they are short of breath.
But the study had a key limitation: All of the enrolled patients had immediate access to health care providers they could contact if they noticed changes in their symptoms or their pulse oximeter readings. A news release notes that for people with COVID-19 who don’t have such immediate access, “self-monitoring with pulse oximeters may still be a reasonable approach until there is evidence to the contrary.”
Similarly, a review of 13 studies that included 2,900 people concluded home pulse oximeters are “pulse oximetry is potentially an effective tool for monitoring deterioration and keeping patients safe at home.” However, further research “should involve more diverse populations, test the system in resource-limited settings, and assess the effect on health outcomes compared with other systems.”
UPenn study co-author Anna Morgan, MD told Verywell that she sees no harm in having a pulse oximeter.
“But if you are otherwise healthy and don’t have one and contract COVID, not having the device is not a reason to panic,” Morgan said. “We learned that the symptom of shortness of breath is telling.”
Who Are Pulse Oximeters Best Suited For?
Before the pandemic, home oximeters were most commonly recommended by doctors to help patients monitor health conditions such as chronic lung disease, shortness of breath, or heart disease, Jonathan Parsons, MD, a pulmonologist at the Ohio State University Wexner Medical Center, told Verywell.
Morgan added pulse oximetry is valuable for COVID-19 patients with underlying lung disease, as well as people who have speech or cognitive difficulties and may not be able to communicate about worsening symptoms.
Who Should Not Use a Pulse Oximeter?
One key limitation of pulse oximeters, which the FDA will be investigating, is that they may not be accurate in people of color.
A January 2021 study by researchers at the University of Michigan found that Black patients were almost three times as likely as White patients to have low oxygen levels that were missed by pulse oximeters.The researchers said that could translate into as many as 1 in 10 inaccurate readings among Black patients and prompted the February 2021 FDA advisory.
The FDA notes that because pulse oximeters use light that passes through the skin to measure oxygen levels, anything that interferes with the light, like a darker skin tone or even nail polish, can cause inaccuracies.
Parsons said that cold hands can also impair readings.
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