Strengths and limitations
hypoxemia, anxiety
The authors performed, to their knowledge, the first entirely primary care-based pilot RCT to assess the feasibility of a trial of home monitoring by pulse oximetry of high-risk patients with COVID-19. Most of the eligible patients were willing to be randomised and adhere to study procedures. The lower than anticipated participation rate was partly owing to a decline in SARS-CoV-2 prevalence in the Netherlands at the end of the study period, and a more widespread use of pulse oximetry by patients with COVID-19. In the study, 8/20 (40.0%) control participants used an ‘own’ pulse oximeter at least once during the study. This could have reduced the contrast between groups, meaning a possible reduction of effect.Overall, in the pilot trial, the use of pulse oximetry tended to reduce anxiety and there were no unsafe situations. A limitation is that an electronic real-time connection was not used between pulse oximeter and medical assistance, so it is possible that detection of hypoxemia measurements was missed or delayed, even though explicit instructions were given to patients when to contact the GP.