Pulse oximeters overestimate SPo2 levels in non-White patients

New York, June 1: Pulse oximeter devices that measure oxygen levels (SPo2) overestimated blood oxygen levels in Covid-19 patients who were non-White, finds a new study.

The findings, published in the journal JAMA Internal Medicine, indicate that overestimation of arterial oxygen saturation levels by pulse oximetry occurs in patients of racial and ethnic minority groups with Covid-19 and contributes to unrecognised or delayed recognition of eligibility to receive Covid-19 therapies.

   

“In this retrospective cohort study of 7,126 patients with Covid-19, an analysis of 1,216 patients with oxygen saturation levels that were concurrently measured by pulse oximetry and arterial blood gas demonstrated that pulse oximetry overestimated arterial oxygen saturation among Asian, Black, and Hispanic patients compared with White patients,” according to the journal.

“Separately, among 6,673 patients with pulse oximetry measurements and available covariate data, predicted overestimation of arterial oxygen saturation levels by pulse oximetry among 1,903 patients was associated with a systematic failure to identify Black and Hispanic patients who were qualified to receive Covid-19 therapy and a statistically significant delay in recognising the guideline-recommended threshold for initiation of therapy,” it added.

For the study, the team looked at patients with Covid-19 in the Johns Hopkins Health System, between March 2020 and November 2021, to determine whether there is a differential inaccuracy of pulse oximetry by race or ethnicity among patients with Covid-19.

The results of this cohort study suggest that racial and ethnic biases in pulse oximetry accuracy were associated with greater occult hypoxemia, a below-normal level of oxygen in your blood, specifically in the arteries, in Asian, Black, and non-Black Hispanic patients with Covid-19, which was associated with significantly delayed or unrecognised eligibility for Covid-19 therapies among Black and Hispanic patients.

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