J Med Internet Res. 2023 Oct 10. doi: 10.2196/47112. Online ahead of print.
ABSTRACT
BACKGROUND: Recent studies have linked a low Heart Rate Variability (HRV) with COVID-19 infection, indicating that this parameter can be a marker of the onset of the disease, its severity, and predictor of mortality in infected people. Given the large offer of wearable devices that capture physiological signals of the human body easily and non-invasive, several studies used this equipment to measure the HRV of individuals and related these measures to the infection by COVID-19.
OBJECTIVE: The objective of this study was to assess the utility of HRV measurements obtained from wearable devices as predictive indicators for COVID-19 infection, as well as the onset and worsening of symptoms in affected individuals.
METHODS: A systematic review was conducted, searching the following databases up to the end of January 2023: Embase, PubMed, Web of Science, Scopus, and IEEE. Studies had to include (I) measures of HRV in patients with COVID-19 and (II) measurements involving the use of wearable devices. We also conducted a meta-analysis of these measures to reduce the possible biases and increase the statistical power of the primary research.
RESULTS: The main result was the association between low HRV and the onset and worsening of COVID-19 symptoms. In some cases, it was possible to predict the onset of COVID-19 before a positive clinical test. The meta-analysis of studies reported shows that a reduction in HRV parameters is associated with COVID-19 infection. Individuals with COVID-19 presented a reduction in the SDNN and RMSSD indices compared to healthy individuals. The decrease in the SDNN index (Standard Deviation of the Normal-to-Normal interbeat interval) was 3.25 ms (95% CI -5.34 to -1.16), and the decrease in the RMSSD index (Root Mean Square Successive Difference) was 1.24 ms (95% CI -3.71 to 1.23).
CONCLUSIONS: Wearable devices that measure changes in HRV, such as smart watches, rings, and bracelets, provide information that allows identifying the COVID-19 infection during the presymptomatic period as well as its worsening, through an indirect and non-invasive self-diagnosis.
CLINICALTRIAL: International Prospective Register of Systematic Reviews (PROSPERO; CRD42023399705).
PMID:37820372 | DOI:10.2196/47112
