The researchers found that the pulse oximeter overestimated blood-oxygen saturation by an average of 1.7 percent for Asian patients, 1.2 percent for Black patients, and 1.1 percent for Hispanic patients. In the first part of the study, researchers compared blood-oxygen saturation for the 1,216 patients who had measurements taken using both a pulse oximeter and arterial blood-gas analysis, which determines the same measure using a direct analysis of blood. To examine how patients with COVID-19 were affected by this flaw in pulse oximeters, researchers used data from over 7,000 COVID-19 patients in the Johns Hopkins hospital system, which includes five hospitals, between March 2020 and November 2021. “If you have melanin, which is the pigment that's responsible for skin color…that could potentially affect the transmittance of the light going through the skin,” said Govind Rao, a professor of engineering and director of the Center for Advanced Sensor Technology at the University of Maryland, Baltimore County, who was not involved in the study. In theory, pulse oximeters shouldn’t be affected by anything other than the levels of oxygen in the blood. These devices infer a patient's blood-oxygen saturation (that is, the percentage of hemoglobin carrying oxygen) from the absorption of light by hemoglobin, the pigment in blood that carries oxygen. Pulse oximeters work by passing light through part of the body, usually a finger. “We found that in Black and Hispanic patients, there was a significant delay in identifying severe COVID compared to white patients.” -Dr. The study adds a growing sense of urgency to an issue raised decades ago. In the first study to examine this issue among COVID-19 patients, published in JAMA Internal Medicinein May, researchers found that the inaccurate measurements resulted in a “systemic failure,” delaying care for many Black and Hispanic patients, and in some cases, preventing them from receiving proper medications. Because low oxygen saturation, called hypoxemia, is a common symptom of COVID-19, low blood-oxygen levels qualify patients to receive certain medications. The agency says it plans to hold a meeting on pulse oximeters later this year. In 2021, the FDA issued a warning about this limitation of pulse oximeters. Tianshi David Wu, an assistant professor of medicine at Baylor College of Medicine, in Houston, and one of the authors of the study.įor decades, scientists have found that pulse oximeters, devices that estimate blood-oxygen saturation, can be affected by a person’s skin color. “That device ended up being essentially a gatekeeper for how we treat a lot of these patients,” said Dr. Inaccurate blood-oxygen measurements, in other words, made by pulse oximeters have had clear consequences for people of color during the COVID-19 pandemic. But, according to new research, pulse oximeters’ performance and accuracy apparently hinges on it. If someone is seeking medical care, the color of their skin shouldn’t matter.
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