Investigation of the use of a sensor bracelet for the presymptomatic detection of changes in physiological parameters related to COVID-19: an interim analysis of a prospective cohort study (COVI-GAPP)

Abstract

ObjectivesWe investigated machinelearningbased identification of presymptomatic COVID-19 and detection of infection-related changes in physiology using a wearable device.DesignInterim analysis of a prospective cohort study.Setting, participants and interventionsParticipants from a national cohort study in Liechtenstein were included. Nightly they wore the Ava-bracelet that measured respiratory rate (RR), heart rate (HR), HR variability (HRV), wrist-skin temperature (WST) and skin perfusion. SARS-CoV-2 infection was diagnosed by molecular and/or serological assays.ResultsA total of 1.5 million hours of physiological data were recorded from 1163 participants (mean age 44±5.5 years). COVID-19 was confirmed in 127 participants of which, 66 (52%) had worn their device from baseline to symptom onset (SO) and were included in this analysis. Multi-level modelling revealed significant changes in five (RR, HR, HRV, HRV ratio and WST) device-measured physiological parameters during the incubation, presymptomatic, symptomatic and recovery periods of COVID-19 compared with baseline. The training set represented an 8-day long instance extracted from day 10 to day 2 before SO. The training set consisted of 40 days measurements from 66 participants. Based on a random split, the test set included 30% of participants and 70% were selected for the training set. The developed long short-term memory (LSTM) based recurrent neural network (RNN) algorithm had a recall (sensitivity) of 0.73 in the training set and 0.68 in the testing set when detecting COVID-19 up to 2 days prior to SO.ConclusionWearable sensor technology can enable COVID-19 detection during the presymptomatic period. Our proposed RNN algorithm identified 68% of COVID-19 positive participants 2 days prior to SO and will be further trained and validated in a randomised, single-blinded, two-period, two-sequence crossover trial.Trial registration numberISRCTN51255782; Pre-results.

The Impact of SARS-CoV-2 Infection on Heart Rate Variability: A Systematic Review of Observational Studies with Control Groups

“…The inter-rater agreement rate among the researchers in the full texts review was 97.67% (42/43). Therefore, 17 observational studies (total participants, N = 3628) [49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65], including a study from other sources [61], were included in this review (Figure 1).…”

“…Of the seventeen included studies, three [49,56,57] were conference abstracts, and fourteen [50][51][52][53][54][55][58][59][60][61][62][63][64][65] were journal articles. Nine studies (52.94%) were conducted in the United States [52][53][54][56][57][58]62,63,65], two (11.76%) were conducted in Turkey [49,61], and the remaining studies were conducted in China [60], India [55], Italy [51], Serbia [59], Spain [50] and Switzerland [64]. A total of four study types were analyzed, including four case-control studies [49,55,59,65], six retrospective analyses [54,[56][57][58]61,63], three crosssectional studies [51,52,60], and fo...…”

“…Of the seventeen included studies, three [49,56,57] were conference abstracts, and fourteen [50][51][52][53][54][55][58][59][60][61][62][63][64][65] were journal articles. Nine studies (52.94%) were conducted in the United States [52][53][54][56][57][58]62,63,65], two (11.76%) were conducted in Turkey [49,61], and the remaining studies were conducted in China [60], India [55], Italy [51], Serbia [59], Spain [50] and Switzerland [64]. A total of four study types were analyzed, including four case-control studies [49,55,59,65], six retrospective analyses [54,[56][57][58]61,63], three cross-sectional studies [51,52,60], and four prospective cohort studies…”

“…Nine studies (52.94%) were conducted in the United States [52][53][54][56][57][58]62,63,65], two (11.76%) were conducted in Turkey [49,61], and the remaining studies were conducted in China [60], India [55], Italy [51], Serbia [59], Spain [50] and Switzerland [64]. A total of four study types were analyzed, including four case-control studies [49,55,59,65], six retrospective analyses [54,[56][57][58]61,63], three cross-sectional studies [51,52,60], and four prospective cohort studies [50,53,62,64]. Eleven studies [49,[51][52][53]55,[57][58][59]61,62,65] included SARS-CoV-2 negative individuals or healthy controls as the control group.…”

“…Eight studies included COVID-19 patients with different clinical manifestations (e.g., symptomatic or asymptomatic) [49,55,57], severity (e.g., mild or severe) [59,60], and clinical outcomes (e.g., mortality) [50,56,63] as a control group. Two studies included a self-control group, where Junarta et al [54] compared pre-COVID-19 and post-COVID-19-related hospitalization in patients with chronic atrial fibrillation (cAF), and Risch et al [64] compared changes in HRV parameters according to each stage in COVID-19 patients, including baseline, incubation, presymptomatic, symptomatic, and recovery stages. There were five studies [49,58,60,61,63] reporting history of cardiovascular conditions, and among them, four [49,60,61,63] reported that there was no statistically significant difference in cardiovascular condition between groups.…”