Multiparameter diagnostic sensor measurements in heart failure patients presenting with SARS‐CoV‐2 infection

Abstract

Aims Implantable device‐based sensor measurements including heart sounds, markers of ventilation, and thoracic impedance have been shown to predict heart failure (HF) hospitalizations. We sought to assess how these parameters changed prior to COVID‐19 (Cov‐19) and how these compared with those presenting with decompensated HF or pneumonia. Methods and results This retrospective analysis explores patterns of changes in daily measurements by implantable sensors in 10 patients with Cov‐19 and compares these findings with those observed prior to HF ( n = 88) and pneumonia ( n = 12) hospitalizations from the MultiSENSE, PREEMPT‐HF, and MANAGE‐HF trials. The earliest sensor changes prior to Cov‐19 were observed in respiratory rate (6 days) and temperature (5 days). There was a three‐fold to four‐fold greater increase in respiratory rate, rapid shallow breathing index, and night heart rate compared with those presenting with HF or pneumonia. Furthermore, activity levels fell more in those presenting with Cov‐19, a change that was often sustained for some time. In contrast, there were no significant changes in 1st or 3rd heart sound (S 1 and S 3 ) amplitude in those presenting with Cov‐19 or pneumonia compared with the known changes that occur in HF decompensation. Conclusions Multi‐sensor device diagnostics may provide early detection of Cov‐19, distinguishable from worsening HF by an extreme and fast rise in respiratory rate along with no changes in S3.

A reproducible sensor pattern to suspect COVID19 pulmonary infection with LATITUDE. Case report and literature review

“…The earliest sensor change was the RR, followed by temperature. 13 Furthermore, no significant changes in S1 and S3 amplitude were detected when comparing HF patients to COVID-19 and non-COVID-19 pneumonia patients. 13 The present case and the literature review show that LATITUDE remote monitoring algorithm may become a useful tool to remotely detect SARS-CoV-2 infection, distinguish it from HF and lead to an early hospitalization for symptomatic patients or to a simple home monitoring.…”

“…Interestingly, the ITI was significantly higher in COVID‐19 patients as compared only with HF patients; indeed no significant change in ITI was detected when comparing COVID‐19 patients to non‐COVID‐19 pneumonia patients, suggesting an underlying pathophysiological mechanism related to pulmonary infection. The earliest sensor change was the RR, followed by temperature 13 . Furthermore, no significant changes in S1 and S3 amplitude were detected when comparing HF patients to COVID‐19 and non‐COVID‐19 pneumonia patients 13 …”

“…The earliest sensor change was the RR, followed by temperature 13 . Furthermore, no significant changes in S1 and S3 amplitude were detected when comparing HF patients to COVID‐19 and non‐COVID‐19 pneumonia patients 13 …”

“…Eventually, Gardner et al. 13 retrospectively compared the HL patterns of changes in three subsets of patients: patients with SARS‐CoV‐2 infection, HF patients or non‐COVID‐19 pneumonia patients. Their findings are consistent with our observations: in COVID‐19 patients the RR, temperature and nHR were significantly increased, while activity level accordingly fell as compared to patients with HF or non‐COVID‐19 pneumonia.…”

“…Eventually, Gardner et al 13 . retrospectively compared the HL patterns of changes in three subsets of patients: patients with SARS‐CoV‐2 infection, HF patients or non‐COVID‐19 pneumonia patients.…”