Remote management of covid-19 using home pulse oximetry and virtual ward support

Abstract

Low blood oxygen—technically, hypoxaemia but usually referred to as hypoxia—can be defined as a measured oxygen saturation below 94% in the absence (or below 88% in the presence) of chronic lung disease.1 In most patients who die of acute covid-19, the initial illness advances insidiously, sometimes with “silent hypoxia” (hypoxia without clinically perceptible symptoms of dyspnoea2 3), leading to pneumonia followed by acute respiratory distress syndrome,usually inweek 2.4 Theunderlying pathology in covid-19 related hypoxia is probably a ventilation-perfusion mismatch,5 caused by a combinationof intrapulmonary shunting, loss of lung perfusion regulation, intravascular microthrombi, and reduced lung compliance leading to alveolar collapse.2 6 7