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

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Many patients hospitalised with acute covid-19 have severe hypoxia. Hypoxia, silent hypoxia, and the need for supplementary oxygen are all independent predictors of worse outcomes in covid-19. Novel prognostic tools such as the 4C score have shown the importance of identifying hypoxia early, and there are physiological reasons for managing the complication promptly and actively.

Pulse oximeters do not save lives, good clinical care does. There is a world of difference between the patient who is given a pulse oximeter and symptom diary and told to contact the health service if they deteriorate and the patient who is given the same equipment, shown how to use it, and who then receives regular calls from a healthcare professional.

This is the rationale behind the virtual ward remote monitoring model for covid-19, which has been introduced in some settings (including, in England, the Covid Oximetry@Home service led from primary care and post-hospital assessment models led from secondary care ).  Figure  shows a flowchart for selecting patients for, and supporting them in, a home oximetry and virtual ward service.

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