Asian, black and Hispanic patients with COVID-19 have persistent overestimation of arterial oxygen saturation, according to a study published online May 31 JAMA Internal Medicine.
Ashraf Fawzy, MD, MPH, of the Johns Hopkins University School of Medicine in Baltimore, and colleagues conducted a retrospective cohort study of clinical data for COVID-19 patients who self-identified as Asian, Black, Hispanic, or White from five referral centers and community hospitals. At the same time, measurements of oxygen saturation in arterial blood (SaO2) and by pulse oximetry (SpO2); the proportion of patients with occult hypoxemia was compared by race and ethnicity. A total of 32,282 concurrent SpO measurements were taken from a total of 1,216 patients2 and SaO2.
The researchers found that occult hypoxemia occurred in 30.2, 28.5, and 29.8 percent of Asian, Black, and non-Black Hispanic patients, respectively, compared to 17.2 percent of White patients. SpO2 SaO overestimated2 by an average of 1.7, 1.2, and 1.1 percent in Asian, Black, and Non-Black Hispanic patients, respectively, compared to White patients. Black and non-black Hispanic patients had a lower risk of eligibility for treatment (hazard ratios, 0.71 and 0.77, respectively). Overall, 23.7 percent of patients were never recognized as eligible for treatment; 54.8 percent of these patients were black. Of those patients ultimately recognized as eligible for treatment, black patients had a median delay of 1.0 hour compared to white patients.
“Different pulse oximetry inaccuracies should be investigated as a possible explanation for differences in COVID-19 outcomes and may have implications for monitoring and management of other respiratory diseases,” the authors write.
One author disclosed financial ties to the pharmaceutical industry.
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