Trial calls into question effectiveness of home pulse oximetry for COVID-19 patients

PHILADELPHIA – The addition of home pulse oximetry to remote monitoring for patients with test-confirmed COVID-19 did not result in a greater number of days alive and out of the hospital than subjective assessments of dyspnea alone, according to a trial conducted by physicians and other health care professionals at the University of Pennsylvania. 

Twenty-eight physicians and other health care professionals from the Perelman School of Medicine published a letter to the editor in the New England Journal of Medicine on April 6 with the findings from their randomized trial assessing a text message-based remote monitoring program supplemented with monitoring of oxygen saturation by home pulse oximeter. 

As part of the trial, they enrolled adults in their health system’s electronic health record with COVID-19 into COVID Watch, a two-week program involving twice daily automated text messages inquiring about dyspnea, with rapid callbacks from nurses when appropriate.  

From Nov. 29, 2020, to Feb. 5, 2021, they randomly assigned patients in the program to participate in the standard monitoring program in addition to home pulse oximetry, or the standard program alone, in a 1:1 ratio. They provided patients in the pulse oximetry group with a pulse oximeter and monitored them for subjective symptoms or a low or declining oxygen saturation. A total of 1,041 patients (606 of whom had test-confirmed COVID-19) were assigned to the standard program group, and 1056 patients (611 of whom had test-confirmed COVID-19) were assigned to the pulse oximetry group. Among patients in the pulse oximetry group, 77.7% submitted at least one pulse oximetry reading.  

Among patients with test-confirmed COVID-19, they found there was no significant between-group difference in the number of days they were alive and out of the hospital at 30 days (mean, 29.4 days in the pulse oximetry group and 29.5 days in the standard program group; P=0.58; difference, −0.1 days; 95% confidence interval [CI], −0.4 to 0.2)