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Is pulse oximeter a reliable tool for non-critically ill patients with COVID-19?
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  • Aslıhan Gürün Kaya,
  • Miraç Öz,
  • İREM AKDEMİR KALKAN,
  • Ezgi Gülten,
  • güle AYDIN,
  • Alpay Azap,
  • Akin Kaya
Aslıhan Gürün Kaya
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Miraç Öz
Ankara University Faculty of Medicine
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İREM AKDEMİR KALKAN
Ankara University Faculty of Medicine
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Ezgi Gülten
Ankara University Faculty of Medicine
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güle AYDIN
Ankara University Faculty of Medicine
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Alpay Azap
Ankara University Faculty of Medicine
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Akin Kaya
Ankara University Faculty of Medicine
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Abstract

Introduction: Guidelines recommend using a pulse oximeter rather than arterial blood gas (ABG) for COVID-19 patients. However, significant differences can be observed between oxygen saturation measured by pulse oximetry (SpO2) and arterial oxygen saturation (SaO2) in some clinical conditions. We aimed to assess the reliability of pulse oximeter in patients with COVID-19 Methods: We retrospectively reviewed ABG analyses and SpO2 levels measured simultaneously with ABG in patients hospitalized in COVID-19 wards. Results: We categorized total 117 patients into two groups; in whom the difference between SpO2 and SaO2 was 4% (acceptable difference) and >4% (large difference). Large difference group exhibited higher neutrophil count, C-reactive protein, ferritin, fibrinogen, D-dimer and lower lymphocyte count. Multivariate analyses revealed that increased fibrinogen, increased ferritin and decreased lymphocyte count were independent risk factors for large difference between SpO2 and SaO2. The total study group demonstrated the negative bias of 4.02% with the limits of agreement of −9.22% to 1.17%. The bias became significantly higher in patients with higher ferritin, fibrinogen levels and lower lymphocyte count. Conclusion: Pulse oximeters may not be sufficient to assess actual oxygen saturation especially in COVID-19 patients with high ferritin and fibrinogen levels and low lymphocyte count low SpO2 measurements.
06 Aug 2021Submitted to International Journal of Clinical Practice
07 Aug 2021Submission Checks Completed
07 Aug 2021Assigned to Editor
22 Aug 2021Reviewer(s) Assigned
24 Aug 2021Review(s) Completed, Editorial Evaluation Pending
30 Aug 2021Editorial Decision: Revise Minor
22 Sep 20211st Revision Received
23 Sep 2021Submission Checks Completed
23 Sep 2021Assigned to Editor
23 Sep 2021Review(s) Completed, Editorial Evaluation Pending
23 Sep 2021Reviewer(s) Assigned
10 Oct 2021Editorial Decision: Accept