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In an article in the New York Times, American emergency physician Richard Levitan told a story about the ten days he spent caring for Covid-19 patients in a New York hospital and warned that pneumonia caused the new coronavirus to evolve silently, so its severity.
How, then, to identify cases before they become serious?
Levitan wrote: “There is a way to identify more patients who have Covid pneumonia earlier and treat them more effectively, and that would not require waiting for a coronavirus test in the hospital or in a doctor’s office. It is to detect hypoxia early. . [privação de oxigênio] Quiet, using standard medical equipment that can be bought without a prescription at most pharmacies – a pulse oximeter. “
According to him, generalized pulse oximetry for Covid’s pneumonia, whether at home or in clinics or hospitals, could offer an early warning for the types of respiratory problems associated with Covid’s pneumonia.
Doctors heard by Sheet They claim that the use of the oximeter can help in the early diagnosis of the disease, but they make many reservations. Medical guidance is required to read the device correctly and what its result means; there would not be enough devices for massive use by the population; people with chronic illnesses may have more benefits; and the oximeter alone does not indicate Covid-19 or its deterioration.
The pulse oximeter is a device similar to a preacher, used on the finger to measure the saturation of oxygen carried in the blood. It uses a light beam to measure how much oxygen the hemoglobins carry.
Because Covid-19 lowers blood oxygen levels even though patients don’t always feel short of breath, which is why Levitan says the disease kills silently, the oximeter might indicate oxygen starvation before for the symptom to appear.
The problem is that hypoxia is only one of the suggestive signs of Covid-19.
“It is appropriate for a person with lung disease to have the device, but using the oximeter as a public measure for the entire population is difficult. “There would not be this many devices available,” says Humberto Bogossian, a pulmonologist at the Israelite Albert Einstein Hospital. “In the hospital, oxygenation below 94% is already a warning sign, but this needs to be evaluated in conjunction with imaging tests. In Covid-19 pneumonia, low oxygenation is just one of several signs of attention.”
The normal concentration of oxygen carried by the blood, according to the medical standard for healthy people without chronic respiratory or cardiovascular diseases, must be equal to or greater than 96%.
A concentration of 92% or less indicates an alert to the possibility of some alteration in the transport of oxygen by the body. If the measurement indicates a percentage of 89% or less, the lack of oxygenation is considered serious.
Pulmonologist at Sírio-Libanês Hospital, André Nathan, says that using the device at home can be beneficial against coronavirus if the person has been well guided by a doctor or is being followed by a health professional, due to misinterpretation. Measurement results can lead a healthy person to go to the hospital unnecessarily, increasing the risk of coronavirus infection. The warning was also made by Bogossian.
Levitan recommends that the device be used by patients who have tested positive for coronavirus, people with a cough, fatigue and fever and people with a negative rapid test, because they are only 70% accurate.
In addition, the person may experience difficulty breathing without decreased oxygenation. “If oxygenation drops to abnormal levels between one measurement and another [feita em casa]There is no doubt that the patient should seek a hospital. The drop in oxygenation is a severity and follow-up criterion for Covid-19, but it is possible for a person to experience great difficulty breathing without reducing oxygenation, “says Nathan.
For this reason, pulmonologists indicate attention to the other symptoms of Covid-19: fever, headaches and body aches, runny nose, and shortness of breath. If symptoms continue, the health service should be sought and suspected infection with the new coronavirus should be reported, even if the measurement of oxygenation indicates normality.
The decision to purchase a device, therefore, should ideally be made with a healthcare professional. Nathan argues that preference should be given to people who are part of the Covid-19 risk group, such as people over 60 or with chronic respiratory or cardiovascular disease.
According to pulmonologists, the measurement should not be performed with cold hands, because the blood circulation in the fingertips decreases and can generate adulterated results. Before using the appliance, it is recommended to warm your hands.
It is also not recommended that the measurement be performed on an enamelled finger, because the enamel, especially dark in color, according to Nathan, prevents the light beam from the device from passing through the tissues and obtaining accurate results.
Bogossian says that ordinary pulse oximeters, which are sold in drugstores and specialty medical device stores, are of good quality and that the margin of error in measurement compared to blood testing with samples is 2 percentage points up. or down. less Models cost between R $ 70 and R $ 250.
However, cell-applied oximeters have not been shown to be effective.
