Mount Sinai researchers are the latest to share data indicating that consumer wearable devices can help signal new cases of COVID-19 before molecular diagnosis.
Accepted for publication in the Journal of Medical Internet Research, the institution’s Warrior Watch study provided Mount Sinai Health System workers with an Apple Watch and a personalized study app. The results highlight significant differences in the heart rate variability (HRV) metric during the seven days prior to the diagnosis of CRP COVID-19 and the following seven days.
“[This study] shows that we can use these technologies to better serve evolving health needs, which will hopefully help us improve disease management, “Dr. Robert P. Hirten, assistant professor of medicine at the Icahn School of Medicine in Mount Sinai and the correspondents of the study author, said in a statement. “Our goal is to operationalize these platforms to improve the health of our patients and this study is a significant step in that direction. Developing a way to identify people who may be sick before they even know they are infected would be a major step forward in the management of COVID-19. “
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TOPLINE DATA
The final data set included 297 participants who completed an average 42-day follow-up. The median age at registration was 36 years old and 69% were women. Prior to enrollment, 20 participants reported a positive COVID-19 nasal PCR test prior to enrollment, while 28 reported a positive COVID-19 blood antibody test. Thirteen participants reported a positive CRP test during the follow-up period of the study.
There was a significant difference in the mean amplitude of the standard deviation of the interval between beats of normal sinus beat (SDNN) circadian patterns – a HRV metric, which is linked to the function of the nervous system – between those with and without COVID-19 (P = .006). These measures also differed when examining the seven-day period before a positive COVID-19 diagnosis for readings from uninfected participants (P = .01).
The HRV patterns of the participants began to normalize within 7 to 14 days after the diagnosis of COVID-19. And while most participants in the study cohort were asymptomatic, the researchers said they also observed a significant change in several measures of circadian pattern when comparing the first day that a symptom related to COVID-19 was reported with every other day of side dish.
“This technology allows us to not only track and predict health outcomes, but also to intervene in a timely and remote manner, which is essential during a pandemic that requires people to be separated,” Zahi Fayad, professor at the Icahn School of Medicine in Monte Sinai and a co-author of the study said in a statement.
HOW IT WAS DONE
Between April 20 and September 29, 2020, the observational study enrolled Mount Sinai healthcare professionals who owned an iPhone Series 6 smartphone or higher and who owned or were willing to wear an Apple Watch Series 4 smartwatch or higher. Those who had an underlying autoimmune disease or were on drugs that interfere with the function of the autonomic nervous system were excluded.
These participants completed baseline research questionnaires and diaries through the study’s personalized application, the latter focusing on the symptoms of COVID-19, diagnostic test results and exposure due to patient care.
During that time, they were also instructed to use the Apple Watch for at least eight hours a day. The device captured HRV using its integrated cardiac optical photoplethysmogram (PPG) sensor and transferred the readings to the study application after completing the daily survey. The researchers then analyzed changes in HRV curves to determine any association with the diagnosis and symptoms of COVID-19, as well as whether COVID-19 could be predicted using the collected data.
WHAT IS THE BACKGROUND
The Mount Sinai wearable study is one of several efforts using wearables to better characterize COVID-19 infection and detect early warning signs of the disease.
Among the most prominent studies is the DETECT program by the Scripps Research Translational Institute, which received wide support from Fitbit. The wearable manufacturer also led its own review of user data, whose initial results support the early diagnosis of new infections before the onset of symptoms (a finding that appears to have caught the attention of the U.S. Army).
Other projects in this area include a recent article describing early detection capabilities among study participants using the Oura ring and Evidation Health’s ongoing collaboration with the National Institutes of Health that is analyzing wearable data for COVID-19 warning signs early.
TO COMPLETE
“These preliminary results support further assessment of HRV as a biomarker of SARS-CoV-2 infection through remote sensing,” the researchers wrote. “Although more studies are needed, this may allow the identification of SARS-CoV-2 infection during the pre-symptomatic period, in asymptomatic patients and before the diagnosis by SARS-CoV-2 nasal PCR tests. These findings justify a further evaluation of this approach to track and identify COVID-19 infections and possibly other types of infections. “