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Assessing the Safety of Home Oximetry for Covid-19: A multi-site retrospective observational study

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Title: Assessing the Safety of Home Oximetry for Covid-19: A multi-site retrospective observational study
Authors: Clarke, J
Flott, K
Crespo, R
Ashrafian, H
Fontana, G
Benger, J
Darzi, A
Elkin, S
Item Type: Journal Article
Abstract: Objectives To determine the safety and effectiveness of home oximetry monitoring pathways safe for Covid-19 patients in the English NHS. Design Retrospective, multi-site, observational study of home oximetry monitoring for patients with suspected or proven Covid-19 Setting This study analysed patient data from four Covid-19 home oximetry pilot sites in England across primary and secondary care settings. Participants A total of 1338 participants were enrolled in a home oximetry programme across four pilot sites. Participants were excluded if primary care data and oxygen saturations are rest at enrolment were not available. Data from 908 participants was included in the analysis. Interventions Home oximetry monitoring was provided to participants with a known or suspected diagnosis of Covid-19. Participants were enrolled following attendance to emergency departments, hospital admission or referral through primary care services. Results Of 908 patients enrolled into four different Covid-19 home oximetry programmes in England, 771 (84.9%) had oxygen saturations at rest of 95% or more, and 320 (35.2%) were under 65 years of age and without comorbidities. 52 (5.7%) presented to hospital and 28 (3.1%) died following enrolment, of which 14 (50%) had Covid-19 as a named cause of death. All-cause mortality was significantly higher in patients enrolled after admission to hospital (OR 8.70 [2.53-29.89]), compared to those enrolled in primary care. Patients enrolled after hospital discharge (OR 0.31 [0.15-0.68]) or emergency department presentation (OR 0.42 [0.20-0.89]) were significantly less likely to present to hospital than those enrolled in primary care. Conclusions This study find that home oximetry monitoring can be a safe pathway for Covid-19 patients; and indicates increases in risk to vulnerable groups and patients with oxygen saturations < 95% at enrolment, and in those enrolled on discharge from hospital. Findings from this evaluation have contributed to the national implementation of home oximetry across England.
Issue Date: 14-Sep-2021
Date of Acceptance: 9-Aug-2021
URI: http://hdl.handle.net/10044/1/91064
DOI: 10.1136/bmjopen-2021-049235
ISSN: 2044-6055
Publisher: BMJ Journals
Start Page: 1
End Page: 9
Journal / Book Title: BMJ Open
Volume: 11
Copyright Statement: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
Sponsor/Funder: National Institute for Health Research
Wellcome Trust
National Institute of Health Research
Funder's Grant Number: n/a
UNS81609 - 215938/Z/19/Z
Keywords: Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
COVID-19
telemedicine
primary care
public health
respiratory medicine (see thoracic medicine)
CARE
COVID-19
primary care
public health
respiratory medicine (see thoracic medicine)
telemedicine
COVID-19
Humans
Oximetry
Retrospective Studies
SARS-CoV-2
State Medicine
Humans
Oximetry
Retrospective Studies
State Medicine
COVID-19
SARS-CoV-2
1103 Clinical Sciences
1117 Public Health and Health Services
1199 Other Medical and Health Sciences
Publication Status: Published
Online Publication Date: 2021-09-04
Appears in Collections:Department of Surgery and Cancer
Mathematics
Applied Mathematics and Mathematical Physics
Faculty of Medicine
Institute of Global Health Innovation
Imperial College London COVID-19
School of Public Health
Faculty of Natural Sciences