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A pulse oximeter can detect early signs of Covid pneumonia

PatJ

Forum Support Assistant
Messages
5,288
Location
Canada
This article on the New York Times explains how a pulse oximeter is an important tool for monitoring the health of covid patients, and even for people who didn't realize they were infected: The infection that's silently killing Coronavirus patients.

Here are some extracts from the article. I've bolded a few sections that are especially important.
Even patients without respiratory complaints had Covid pneumonia. The patient stabbed in the shoulder, whom we X-rayed because we worried he had a collapsed lung, actually had Covid pneumonia. In patients on whom we did CT scans because they were injured in falls, we coincidentally found Covid pneumonia. Elderly patients who had passed out for unknown reasons and a number of diabetic patients were found to have it.

And here is what really surprised us: These patients did not report any sensation of breathing problems, even though their chest X-rays showed diffuse pneumonia and their oxygen was below normal. How could this be?

We are just beginning to recognize that Covid pneumonia initially causes a form of oxygen deprivation we call “silent hypoxia” — “silent” because of its insidious, hard-to-detect nature.

Pneumonia is an infection of the lungs in which the air sacs fill with fluid or pus. Normally, patients develop chest discomfort, pain with breathing and other breathing problems. But when Covid pneumonia first strikes, patients don’t feel short of breath, even as their oxygen levels fall. And by the time they do, they have alarmingly low oxygen levels and moderate-to-severe pneumonia (as seen on chest X-rays). Normal oxygen saturation for most persons at sea level is 94 percent to 100 percent; Covid pneumonia patients I saw had oxygen saturations as low as 50 percent.

To my amazement, most patients I saw said they had been sick for a week or so with fever, cough, upset stomach and fatigue, but they only became short of breath the day they came to the hospital. Their pneumonia had clearly been going on for days, but by the time they felt they had to go to the hospital, they were often already in critical condition.
...

A vast majority of Covid pneumonia patients I met had remarkably low oxygen saturations at triage — seemingly incompatible with life — but they were using their cellphones as we put them on monitors. Although breathing fast, they had relatively minimal apparent distress, despite dangerously low oxygen levels and terrible pneumonia on chest X-rays.
...

Silent hypoxia progressing rapidly to respiratory failure explains cases of Covid-19 patients dying suddenly after not feeling short of breath.

And the important take-away message:
There is a way we could identify more patients who have Covid pneumonia sooner and treat them more effectively — and it would not require waiting for a coronavirus test at a hospital or doctor’s office. It requires detecting silent hypoxia early through a common medical device that can be purchased without a prescription at most pharmacies: a pulse oximeter.
...

Widespread pulse oximetry screening for Covid pneumonia — whether people check themselves on home devices or go to clinics or doctors’ offices — could provide an early warning system for the kinds of breathing problems associated with Covid pneumonia.
...

All patients who have tested positive for the coronavirus should have pulse oximetry monitoring for two weeks, the period during which Covid pneumonia typically develops. All persons with cough, fatigue and fevers should also have pulse oximeter monitoring even if they have not had virus testing, or even if their swab test was negative, because those tests are only about 70 percent accurate. A vast majority of Americans who have been exposed to the virus don’t know it.

A doctor in the comments section of the article said it would be a good for medical providers to add a pulse oximetry check when doing a swab test and temperature check.
 

Booble

Senior Member
Messages
1,397
When I was sick recently I happen to have a pulse oximeter around that was from my parents who both passed away in the last few years. I had a bad cough and checked my oxygen level often. It never dropped below 95 but I was ready to turn on a dime and see a doctor if it did. When I did go to a doctor after about 3 weeks sick, they did do pulse oximetry as a matter of course as part of the intake along with temperature and blood pressure.
 

Mary

Moderator Resource
Messages
17,335
Location
Southern California
Cort has done an article on this: https://www.healthrising.org/blog/2020/04/22/coronavirus-silent-hypoxia-pulse-oximeter/
How are COVID-19 patients managing to get so ill without their knowing it? Probably because of the way the virus attacks the air sacs or alveoli in the lungs. Initially, COVID-19 prevents these air sacs from expanding to take in oxygen, but until the inflammation cuts in, their air sacs are still able to expel CO2 – and it’s the buildup of CO2 that leaves us short of breath, not low amounts of oxygen.

People with COVID-19 are compensating for the damage to their air sacs by taking faster, deeper breaths – not knowing that doing so causes more inflammation, more damage to the air sacs, and ultimately, a faster progression of their pneumonia.

By the time some people actually have trouble breathing, their lungs have been so damaged that they have to immediately go on a ventilator. So much damage can unknowingly occur that some COVID-19 patients die shortly after experiencing shortness of breath.
 

Tammy

Senior Member
Messages
2,181
Location
New Mexico
Pulse oximeters next item that will be hard to find available! I am able to order some things out of a catalog that are covered by my insurance. Tried to order a pulse oximeter this morning..........and they are out of stock already.
 

Mary

Moderator Resource
Messages
17,335
Location
Southern California
Pulse oximeters next item that will be hard to find available! I am able to order some things out of a catalog that are covered by my insurance. Tried to order a pulse oximeter this morning..........and they are out of stock already.
There are some available on Amazon but I'm guessing your insurance wouldn't cover them. Yeah, not surprising they're getting sold out! But I think it may be like toilet paper and more will be available soon. I bought one several years ago as I wanted to see what my oxygen levels were like when I was crashed - if I could get any more clues about PEM - but my levels didn't waver, they stayed normal even while crashed. And amazingly I still have it - I lose so many things!
 

bertiedog

Senior Member
Messages
1,738
Location
South East England, UK
Mine arrived today via eBay but was a bit surprised to find my oxygen sats after doing some gardening was only 92%. It didn't really raise until I had a bit of extra steroid did afternoon and used 30 minutes of my oxygen concentrator and then they went up to 99%. Couldn't get them up to that level earlier in the day at all. Its gone back to 93% now even though I am resting.

BTW There is nothing wrong with my lungs at all they are actually very strong, its my muscles that are the problem!

Pam