COVID-19 is a global pandemic with significant case fatality, often due to respiratory failure. Few treatments have improved morbidity, and the only pharmacologic intervention reported to improve survival is use of glucocorticoids in hospitalized COVID-19 patients requiring supplemental oxygen. The National Institutes of Health recommends maintaining oxygen saturation levels at 92%-96 for COVID-19 patients. COVID-19 patients often have unrecognized hypoxemia without experiencing overt respiratory symptoms, resulting in a missed opportunity to institute potentially life-saving treatment.

While the Centers for Disease Control (CDC) and World Health Organization (WHO) advise COVID-19 patients to seek medical attention if they have “trouble breathing”, there are no current guidelines to assess objective signs of respiratory insufficiency at home, such as oxygen saturation or respiratory rate. In a study that included patients with one or more comorbidity, the increased mortality risk associated with hypoxemia and tachypnea was present irrespective of the comorbidities.

Admission respiratory status predicts mortality in COVID-19 May 24, 2021

Respiratory compromise at initial presentation that could have been readily measured at home are associated with a higher risk of in-hospital mortality in COVID-19 patients. “Public health strategies emphasizing the importance of at-home surveillance of oxygen saturation and respiratory rate may identify at-risk patients earlier and enable timely institution of life-saving medical therapy”. We are nearing the end of the tunnel however, we aren’t there yet. Please be sure that you are still assessing your residents per current standards of practice including pulse oximetry. Stay well, stay informed and stay tuned!