COVID-19-Induced Changes in Photoplethysmography.
Jacquelin Peck1, Michael J Wishon2, Harrison Wittels2
1Department of Anesthesiology, Massachusetts General Hospital, Boston, MA 02114, USA.
Military Medicine
|February 28, 2023
Summary
Photoplethysmography (PPG) dropouts were observed in 100% of COVID-19 patients, unlike non-COVID controls. This finding suggests PPG dropouts correlate with COVID-19 related hemorheological changes.
Area of Science:
- Biomedical Engineering
- Medical Diagnostics
- Cardiovascular Physiology
Background:
- Photoplethysmography (PPG) is fundamental to devices like pulse oximeters.
- Previous in vitro studies linked PPG changes to clot activation.
- COVID-19 is associated with increased clot formation in arteries, veins, and microvasculature.
Purpose of the Study:
- To investigate the presence of PPG dropouts in COVID-19 patients.
- To evaluate PPG recordings and D-dimer levels in hospitalized COVID-19 patients.
- To compare PPG tracings between COVID-19 patients and non-COVID controls.
Main Methods:
- PPG recordings were acquired from 197 ICU patients with COVID-19 and 300 non-COVID controls.
- A TigerTech CovidPlus monitor with FDA emergency use authorization was used for PPG monitoring.
- D-dimer lab results were collected concurrently with PPG data whenever available.
Main Results:
- A significantly higher prevalence of PPG dropouts was found in COVID-19 patients (100%) compared to non-COVID controls (2.3%).
- The median PPG dropout rate was 0.58 in COVID-19 patients versus 0.0 in controls (P < .05).
- PPG dropout rates strongly correlated with normalized serum D-dimer levels (R² = 0.743, P < .05), indicating hemorheological changes.
Conclusions:
- PPG dropout may serve as an indicator of hemorheological changes in COVID-19.
- While not specific to COVID-19, PPG dropout was statistically observable in vivo due to the disease's inflammatory nature and patient cohort.
- Further research is needed to explore PPG dropout's potential as a marker for inflammation in other conditions.
