Discovering ways to non-invasively early detect COVID-19 from heart rate, sleep, or a cough sound, even among the asymptomatic

Heart rate, sleep quality, daily movement–cough sound frequency? Several studies in the US and UK are attempting to turn up ways to early diagnose mildly symptomatic, asymptomatic, or even pre-symptomatic COVID-19 cases, without the PCR swab or a blood test.

The more obvious of the two comes out of the Scripps Research Translational Institute. The DETECT study started in March (!) with 30,500 participants sending in data in the first six weeks of the study on heart rate, sleep quality, and daily movement. This information was then matched with self-reported symptoms and diagnostic tests taken if any. In this way, new infections and outbreaks could be detected at an earlier stage.  The study is attempting to confirm if changes in those metrics in an individual’s pattern can identify those even at a pre-symptomatic or asymptomatic stage. 3,811 reported symptoms, 54 reported testing positive, and 279 negative for COVID-19. The numbers seem small, but the analysis carries out that the combination of sensor and symptom data performed better in discriminating between positive and negative individuals than symptom reporting alone. The symptom data were taken from Fitbits and any device connected through Apple HealthKit or Google Fit data aggregators, then reported on the research app MyDataHelps. FierceBiotech, Nature Medicine (study)

Also using vital signs, back in August, Fitbit released early data on a 100,000+ study where changes in heart rate and breathing could detect about half of diagnosed cases at least one day to a week before diagnosis. Symptomatic cases were 1,100 in this sample. Heart rate and breathing were detected to become more frequent in the symptomatic, with the variability in time between each heartbeat dropping, resulting in a more steady pulse. The preferred tracking was at night during rest. However, there was a 30 percent false positive rate on the algorithm used, which is extremely high. FierceBiotech Related to this work, Fitbit was selected at the end of October by the US Army Medical Research and Development Command (USAMRDC) to receive nearly $2.5 million from the US Department of Defense through a Medical Technology Enterprise Consortium (MTEC) award to advance a wearable diagnostic capability for the early detection of a COVID-19 infection. Fitbit will be working with Northwell Health’s Feinstein Institutes for Medical Research to validate their early detection algorithm. Business Wire

And what about that ‘Covid Cough’? MIT is researching that this cough is different than other coughs, like from cold or allergy. Their research found that there’s a difference in the sound of an asymptomatic individual’s cough–and that sound frequency difference could not be heard by human ears. (Dog ears perhaps?) MIT researchers created “the largest audio COVID-19 cough balanced dataset reported to date with 5,320 subjects” out of 70,000 cough samples. The algorithm performed well. “When validated with subjects diagnosed using an official test, the model achieves COVID-19 sensitivity of 98.5% with a specificity of 94.2% (AUC: 0.97). For asymptomatic subjects it achieves sensitivity of 100% with a specificity of 83.2%.” This sure sounds like an AI screening tool that is inexpensive and convenient to use with multiple populations even daily. IEEE-EMB  BBC News reports that similar studies are taking place at Cambridge University, Carnegie Mellon University, and UK health start-up Novoic. The Cambridge study used a combination of breath and cough sounds and had an 80 percent success rate in identifying positive coronavirus cases from their base of 30,000 recordings.

All of these will be useful, but still need to be validated–and that takes time, for which this Editor thinks is short as this virus, like others, will eventually 1) mutate out or 2) be effectively treated as we do with normal flus. But down the road, these will serve as a template for new ways for early screening or even diagnosis of other respiratory diseases.

Artificial pancreas for Type 1 diabetics may be closer

A victory in this perpetual Battle of Stalingrad? Three universities, plus Dublin-based Medtronic, are developing devices that may bring a commercial artificial pancreas for Type 1 diabetics to market within the next few years. Medtronic is estimating that their system could be in market by 2017. The University of Virginia‘s Center for Diabetes Technology has a final clinical trial this summer on the inControl system which is being commercialized by start-up company TypeZero Technologies. Other research programs are underway at Cambridge University and Boston University, on a product that will measure both insulin and glucagon. Type 1 diabetics produce no insulin, making their lives literally dependent on close glucose monitoring and correct insulin delivery. These are “closed-loop” systems, consisting of a pump worn outside the body, a continuous glucose monitor, which measures glucose from fluid under the skin, and a device that runs continuous algorithms to determine insulin delivery. Much of this research has been funded by the Juvenile Diabetes Research Foundation (JDRF). Perhaps there will be a better and safer way soon to fight this perpetual Battle of Stalingrad for those with Type 1 diabetes. CNBC

“Who do I call?” when the cyberalarm goes off

[grow_thumb image=”” thumb_width=”175″ /]A top read for the weekend is this short article by Gillian Tett in the FT on the lack of coordination in the US in not only protecting systems from cyberattack, but also the lack of coordination between public and private sectors in protection–and when something does go wrong. As Henry Kissinger famously said about Europe when various crises loomed, ‘who do I call?’

Indicators of a gathering storm are everywhere:

* Wednesday’s hours-long, still unexplained outages at the NYSE and United Airlines. (The Wall Street Journal website going down for a bit was the topping on the jitters)

* A joint report from Cambridge University and Lloyds insurance group, also released Wednesday, estimated that a hack shutting down the US electrical grid would create $1 trillion in damage. (more…)

Inexpensive reusable portable sensors for diabetes, UTI

Responsive holograms that change colour in the presence of certain compounds are being developed into portable medical tests and devices, which could be used to monitor conditions such as diabetes, cardiac function, infections, electrolyte or hormone imbalance easily and inexpensively, according to the University of Cambridge. It is claimed that the technique can be used to test blood, breath, urine, saliva or tears for glucose, alcohol, drugs, bacteria or hormones. Clinical trials are said to be underway to test glucose and urinary tract infections (UTI) in diabetics at Addenbrooke’s Hospital.

It is estimated that the reusable sensors could cost as little as UK £ 0.1 (about US 15 cents) to produce, making them affordable for use in developing countries. A prototype smartphone-based test suitable for both clinical and home testing of diabetes and clinically relevant conditions is under development.

If this is a commercial success this could form the basis of a multi-purpose portable tester suitable for telehealth use.

A research paper, Light-Directed Writing of Chemically Tunable Narrow-Band Holographic Sensors, has been published in Advanced Optical Materials.