A common device used to take the pulse and oxygen levels made nonwhite patients appear healthier than they were and may have delayed the need for COVID-19 treatment, according to a new study out of Johns Hopkins University.
Pulse oximeters are small devices that are clipped to a finger and used to measure a patient’s blood oxygen levels using light wavelengths. However, some studies have recently found accuracy issues in pulse oximeters because of skin pigmentation, according to the FDA.
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In the analysis conducted at Johns Hopkins and Baylor University, researchers compared the blood oxygen levels of over 1,200 patients with COVID using a pulse oximeter and arterial blood gas tests.
The researchers found that the pulse oximeters overestimated the blood oxygen levels in Black patients by 1.2%, 1.1% among Hispanic patients, and 1.7% among Asian patients.
That small percentage can be enough to decide not to use COVID-19 treatments more associated with severe cases because COVID affected oxygen levels in the blood.
The researchers then looked at another 6,600 COVID-19 cases and, through a statistical model, found that Black patients were 29% less likely than white patients to be eligible for treatment based on a pulse oximeter reading. Hispanic patients were 23% less likely.
Because pulse oximeters are less invasive than arterial blood gas tests, the researchers said the devices had become gatekeepers for COVID-19 treatment.
“We’ve shown that biases in pulse oximeter accuracy can mean the difference between receiving a necessary medication and not — and, critically, we were able to quantify how much this disproportionately affects minority communities,” said Dr. Tianshi David Wu, a study co-lead author.
The study was published in the Journal of the American Medical Association.