Sex-specific differences in physiological parameters related to SARS-CoV-2 infections among a national cohort (COVI-GAPP study)

Considering sex as a biological variable in modern digital health solutions, we investigated sex-specific differences in the trajectory of four physiological parameters across a COVID-19 infection. A wearable medical device measured breathing rate, heart rate, heart rate variability, and wrist skin...

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Published inPloS one Vol. 19; no. 3; p. e0292203
Main Authors Grossmann, Kirsten, Risch, Martin, Markovic, Andjela, Aeschbacher, Stefanie, Weideli, Ornella C., Velez, Laura, Kovac, Marc, Pereira, Fiona, Wohlwend, Nadia, Risch, Corina, Hillmann, Dorothea, Lung, Thomas, Renz, Harald, Twerenbold, Raphael, Rothenbühler, Martina, Leibovitz, Daniel, Kovacevic, Vladimir, Klaver, Paul, Brakenhoff, Timo B., Franks, Billy, Mitratza, Marianna, Downward, George S., Dowling, Ariel, Montes, Santiago, Veen, Duco, Grobbee, Diederick E., Cronin, Maureen, Conen, David, Goodale, Brianna M., Risch, Lorenz
Format Journal Article
LanguageEnglish
Published United States Public Library of Science 06.03.2024
Public Library of Science (PLoS)
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Online AccessGet full text
ISSN1932-6203
1932-6203
DOI10.1371/journal.pone.0292203

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Abstract Considering sex as a biological variable in modern digital health solutions, we investigated sex-specific differences in the trajectory of four physiological parameters across a COVID-19 infection. A wearable medical device measured breathing rate, heart rate, heart rate variability, and wrist skin temperature in 1163 participants (mean age = 44.1 years, standard deviation [SD] = 5.6; 667 [57%] females). Participants reported daily symptoms and confounders in a complementary app. A machine learning algorithm retrospectively ingested daily biophysical parameters to detect COVID-19 infections. COVID-19 serology samples were collected from all participants at baseline and follow-up. We analysed potential sex-specific differences in physiology and antibody titres using multilevel modelling and t-tests. Over 1.5 million hours of physiological data were recorded. During the symptomatic period of infection, men demonstrated larger increases in skin temperature, breathing rate, and heart rate as well as larger decreases in heart rate variability than women. The COVID-19 infection detection algorithm performed similarly well for men and women. Our study belongs to the first research to provide evidence for differential physiological responses to COVID-19 between females and males, highlighting the potential of wearable technology to inform future precision medicine approaches.
AbstractList Considering sex as a biological variable in modern digital health solutions, we investigated sex-specific differences in the trajectory of four physiological parameters across a COVID-19 infection. A wearable medical device measured breathing rate, heart rate, heart rate variability, and wrist skin temperature in 1163 participants (mean age = 44.1 years, standard deviation [SD] = 5.6; 667 [57%] females). Participants reported daily symptoms and confounders in a complementary app. A machine learning algorithm retrospectively ingested daily biophysical parameters to detect COVID-19 infections. COVID-19 serology samples were collected from all participants at baseline and follow-up. We analysed potential sex-specific differences in physiology and antibody titres using multilevel modelling and t-tests. Over 1.5 million hours of physiological data were recorded. During the symptomatic period of infection, men demonstrated larger increases in skin temperature, breathing rate, and heart rate as well as larger decreases in heart rate variability than women. The COVID-19 infection detection algorithm performed similarly well for men and women. Our study belongs to the first research to provide evidence for differential physiological responses to COVID-19 between females and males, highlighting the potential of wearable technology to inform future precision medicine approaches.
Considering sex as a biological variable in modern digital health solutions, we investigated sex-specific differences in the trajectory of four physiological parameters across a COVID-19 infection. A wearable medical device measured breathing rate, heart rate, heart rate variability, and wrist skin temperature in 1163 participants (mean age = 44.1 years, standard deviation [SD] = 5.6; 667 [57%] females). Participants reported daily symptoms and confounders in a complementary app. A machine learning algorithm retrospectively ingested daily biophysical parameters to detect COVID-19 infections. COVID-19 serology samples were collected from all participants at baseline and follow-up. We analysed potential sex-specific differences in physiology and antibody titres using multilevel modelling and t-tests. Over 1.5 million hours of physiological data were recorded. During the symptomatic period of infection, men demonstrated larger increases in skin temperature, breathing rate, and heart rate as well as larger decreases in heart rate variability than women. The COVID-19 infection detection algorithm performed similarly well for men and women. Our study belongs to the first research to provide evidence for differential physiological responses to COVID-19 between females and males, highlighting the potential of wearable technology to inform future precision medicine approaches.Considering sex as a biological variable in modern digital health solutions, we investigated sex-specific differences in the trajectory of four physiological parameters across a COVID-19 infection. A wearable medical device measured breathing rate, heart rate, heart rate variability, and wrist skin temperature in 1163 participants (mean age = 44.1 years, standard deviation [SD] = 5.6; 667 [57%] females). Participants reported daily symptoms and confounders in a complementary app. A machine learning algorithm retrospectively ingested daily biophysical parameters to detect COVID-19 infections. COVID-19 serology samples were collected from all participants at baseline and follow-up. We analysed potential sex-specific differences in physiology and antibody titres using multilevel modelling and t-tests. Over 1.5 million hours of physiological data were recorded. During the symptomatic period of infection, men demonstrated larger increases in skin temperature, breathing rate, and heart rate as well as larger decreases in heart rate variability than women. The COVID-19 infection detection algorithm performed similarly well for men and women. Our study belongs to the first research to provide evidence for differential physiological responses to COVID-19 between females and males, highlighting the potential of wearable technology to inform future precision medicine approaches.
Audience Academic
Author Risch, Martin
Hillmann, Dorothea
Kovac, Marc
Dowling, Ariel
Twerenbold, Raphael
Pereira, Fiona
Rothenbühler, Martina
Veen, Duco
Goodale, Brianna M.
Renz, Harald
Lung, Thomas
Conen, David
Wohlwend, Nadia
Mitratza, Marianna
Montes, Santiago
Grossmann, Kirsten
Risch, Corina
Weideli, Ornella C.
Kovacevic, Vladimir
Aeschbacher, Stefanie
Cronin, Maureen
Markovic, Andjela
Velez, Laura
Risch, Lorenz
Brakenhoff, Timo B.
Franks, Billy
Downward, George S.
Leibovitz, Daniel
Grobbee, Diederick E.
Klaver, Paul
AuthorAffiliation 18 Department of Methodology and Statistics, Utrecht University, Utrecht, The Netherlands
9 Soneva Fushi, Boduthakurufaanu Magu, Male, Maldives
6 Department of Psychology, University of Fribourg, Fribourg, Switzerland
12 Department of Cardiology and University Center of Cardiovascular Science, University Heart and Vascular Center Hamburg, Hamburg, Germany
2 Dr Risch Medical Laboratory, Vaduz, Liechtenstein
8 Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland
19 Optentia Research Programme, North-West University, Potchefstroom, South Africa
5 Ava AG, Zürich, Switzerland
14 UMC Utrecht, Utrecht, The Netherlands
1 Private University in the Principality of Liechtenstein (UFL), Triesen, Principality of Liechtenstein
21 Center of Laboratory Medicine, University Institute of Clinical Chemistry, University of Bern, Inselspital, Bern, Switzerland
7 Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
4 Dr Risch Medical La
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CorporateAuthor on behalf of the COVID-19 remote early detection (COVID-RED) consortium
COVID-19 remote early detection (COVID-RED) consortium
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Full list of group members of the COVID-RED consortium is provided in the acknowledgments.
Competing Interests: The authors have read the journal’s policy and have the following competing interests: Lorenz Risch, and Martin Risch are key shareholders of the Dr Risch Medical Laboratory. David Conen has received consulting fees from Roche Diagnostics, outside of the current work. Andjela Markovic, Vladimir Kovacevic, Martina Rothenbühler, Brianna Goodale and Maureen Cronin are past employees of Ava AG. Brianna Goodale and Timo Brakenhoff are current employees of Julius Clinical BV. Billy Franks is a former employee of Julius Clinical BV and now an employee of Haleon. Paul Klaver and Duco Veen are former employees of Julius Clinical BV. Marianna Mitratza is a current employee of P95 CVBA. There are no patents, products in development or marketed products associated with this research to declare. These competing interests do not alter our adherence to PLOS ONE policies on sharing data and materials.
DEG, MC, DC, BMG and LR also contributed equally to this work.
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Snippet Considering sex as a biological variable in modern digital health solutions, we investigated sex-specific differences in the trajectory of four physiological...
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SubjectTerms Adult
Algorithms
Analysis
Antibodies
Biology and life sciences
Biophysics
Computer and Information Sciences
Control
COVID-19 - diagnosis
Data mining
Development and progression
Epidemics
Female
Heart beat
Humans
Infection
Machine learning
Male
Medicine and Health Sciences
Netherlands
Physical Sciences
Research and Analysis Methods
Retrospective Studies
SARS-CoV-2
Skin
Viral antibodies
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Title Sex-specific differences in physiological parameters related to SARS-CoV-2 infections among a national cohort (COVI-GAPP study)
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https://doi.org/10.1371/journal.pone.0292203
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