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SARS-CoV-2 infection, pulse oximetry, and interpretive caveats
Bharath Chhabria1, Navneet Arora1, Sarah Chahal1
1Departments of Internal medicine, Pulmonary Medicine, 29751Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Tropical Doctor
|July 1, 2022
Summary
Hypoxaemia in COVID-19 patients may not indicate lung issues; consider drug-induced methaemoglobinemia as a cause of
Area of Science:
- Pulmonology
- Clinical Medicine
- Toxicology
Background:
- Hypoxaemia is a common COVID-19 symptom.
- Finger pulse oximetry is widely used for oxygen saturation monitoring.
- COVID-19 can lead to pneumonia and lung fibrosis.
Purpose of the Study:
- To highlight that hypoxaemia in COVID-19 does not always mean lung disease.
- To emphasize the importance of considering methaemoglobinemia in unexplained hypoxaemia.
- To report a case of spurious hypoxia due to methaemoglobinemia in a COVID-19 patient.
Main Methods:
- Case report.
- Review of clinical presentation and laboratory findings.
- Analysis of pulse oximetry readings and blood gas analysis.
Main Results:
- The patient presented with hypoxaemia and cyanosis.
- Methaemoglobinemia was identified as the cause of 'spurious hypoxia'.
- Pulse oximetry readings were inconsistent with arterial blood gas results.
Conclusions:
- Methaemoglobinemia should be considered in COVID-19 patients with unexplained hypoxaemia or saturation gaps.
- Finger pulse oximetry limitations must be recognized.
- Accurate diagnosis requires considering differential diagnoses beyond COVID-19 lung pathology.
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