The continuing battle with the global spread of the novel COVID-19 has emphasized and revitalized the vital role of innovative tools that could help detect symptoms before the clinical condition worsens. Thus, the COVID-19 pandemic has brought about an influx in demand for home monitoring tools, particularly pulse oximeters, since one of the clinical concerns with acquiring a COVID-19 infection is its respiratory effects. Respiratory function, specifically, oxygenation, can be impaired by severe COVID-19 infection. The virus damages the lung, thereby reducing oxygen intake capacity. With pulse oximetry, important data on respiratory parameters are reflected. It could monitor COVID-19 disease progression by measuring the oxygen saturation (SpO2) in a person’s blood.
How Pulse Oximeters Work: Detection of Blood Oxygen Levels
Although people infected with COVID-19 can manifest with varying symptoms, the most common initial symptoms observed in patients are fever, cough, fatigue, and myalgia. Symptoms are then classified as mild, moderate, and severe. Those with mild symptoms and are otherwise healthy are often sent home to manage their symptoms. Pulse oximeters can be useful for these patients. The home pulse oximetry readings can accurately reflect important clinical insight on respiratory deterioration. The blood oxygen level of a person infected with the novel coronavirus may be lower than average. This condition is known as hypoxia. The more severe the infection, the lower the oxygen saturation reading will be. Some patients unknowingly have decreased blood oxygen levels during the early stages of COVID-19. Their clinical status can immediately deteriorate, and they can eventually manifest with shortness of breath, which leads to higher mortality rates. Having a pulse oximeter can detect low blood oxygen levels before the onset of severe symptoms.
A pulse oximeter like the Wellue OxySmart™ is designed as a clip that fits on a person’s fingertips or toes. The Wellue O2Ring™, on the other hand, is a ring-like device that the patient can wear. Both devices make use of light-emitting diodes (LEDs) and a light detector. When the oximeter is attached to the fingertip, the LEDs and the light detector capture blood flow from the small vessels. From this, the device can then measure the percentage of oxygen-carrying blood within seconds. The pulse oximeter also has a monitor that displays the SpO2 rate and a pulse wave, representing the pulse rate. It can be used to determine how much oxygen a patient needs and when they may need it.
Not only could pulse oximeters like Wellue OxySmart™ and O2Ring™ Continuous Ring Oximeter record SpO2, but it could also document the corresponding pulse rate, heart rate, perfusion index, and movements of a person. There is merit in knowing these health parameters, especially SpO2. The National Institutes of Health (NIH) recommends oxygen saturation levels of 92–96%. Anything below this range indicates a severe case of COVID-19 infection, which may require urgent hospitalization for immediate oxygen supplementation and critical care. It is where data collected from a Wellue OxySmart™ and O2 Ring™ Continuous Ring Oximeter can be life-saving.
The use of these devices by generally healthy people and patients diagnosed with mild COVID-19 symptoms cannot aid in establishing whether or not there is a need for them to be hospitalized. However, people can monitor their clinical status even in the comforts of their homes since these devices can instantly analyze the user’s condition.
Benefits and Pitfalls of Pulse Oximetry
Pulse oximeters are not foolproof. The method or technique of measurement can affect the oxygen saturation that will be recorded. Improper placement of these devices can inaccurately reflect oxygen levels in the blood. The best reading can be achieved with a strong pulsatile flow from the site of measurement, granted that the wearer has warm hands and is relaxed.
However, both Wellue OxySmart™ and Wellue O2 Ring™ Continuous Ring Oximeter are FDA-approved wearable electronic devices that can monitor oxygenation continuously, remotely, and noninvasively. The data is gathered in real-time. It is then seamlessly uploaded to a mobile, tablet, or computer app, which can be viewed by the wearer and conveniently shared with a health care provider. This feature will eliminate the need of the user to physically go to the hospital or clinic if it’s only for a check-up. With the data from these devices that they can easily muster, they now have the option to talk to health professionals through online consultations and still have an updated and monitored analysis of their current health condition. Doing so could mean having a smoother and easier online consultation experience. Home monitoring of blood oxygen levels can prevent premature and unnecessary visits to the emergency department and simultaneously optimize in‐person health care utilization. Especially during a pandemic, having an at-home device would be the best option to minimize the risk of getting infected.
Wellue O2 Ring™ Continuous Ring Oximeter allows wearers to capture their SpO2 levels overnight while they are sleeping. The ring vibrates to alert the wearer once their blood oxygen levels fall below the optimal range. This can be particularly helpful in monitoring oxygen saturation in COVID-19 patients while they sleep. Heart rate, respiratory rate, and overall sympathetic tone are decreased during sleep. COVID-19 patients who are already critical would not be able to tolerate a fall in sympathetic tone since this can further aggravate hypoxia. The ring oximeter readings can be used to assess oxygenation in patients under critical care. It can help detect early decompensation and subsequently allow healthcare professionals to deploy resuscitative measures.
All in all, pulse oximeter readings may not reveal the severity of the disease process, and patients should, therefore, always seek further medical evaluation if they are experiencing any COVID19 related symptoms. They should not solely rely on these devices to detect medical conditions such as COVID-19, COPD, pneumonia, asthma, and other disease entities with a failure in oxygen supply. Pulse oximeter devices are used mostly for conveniently monitoring the wearer’s current health condition. It is also a great tool to determine the consistency of their health, as well as a warning device that can help the patient be more conscious of their health insights.
- Shenoy, N., Luchtel, R. & Gulani, P. Considerations for target oxygen saturation in COVID-19 patients: are we under-shooting?. BMC Med 18, 260 (2020). https://doi.org/10.1186/s12916-020-01735-2
- Shah, S., Majmudar, K., Stein, A., Gupta, N., Suppes, S., Karamanis, M., … Patte, C. (2020). Novel use of home pulse oximetry monitoring in COVID‐19 patients discharged from the emergency department identifies need for hospitalization. Academic Emergency Medicine. doi:10.1111/acem.14053
- Singh, S., Khan, S. Z., Singh, D., Verma, S., & Talwar, A. (2020). The uses of overnight pulse oximetry. Lung India: official organ of Indian Chest Society, 37(2), 151–157. https://doi.org/10.4103/lungindia.lungindia_302_19
- American Thoracic Society (2018). ATS Patient Education Series: Pulse Oximetry. American Thoracic Society. https://www.thoracic.org/patients/patient-resources/resources/pulse-oximetry.pdf