Informatics and Knowledge Management Graduate Program, Universidade Nove de Julho, São Paulo, Brazil.
J Med Internet Res. 2023 Nov 14;25:e47112. doi: 10.2196/47112.
Recent studies have linked low heart rate variability (HRV) with COVID-19, indicating that this parameter can be a marker of the onset of the disease and its severity and a predictor of mortality in infected people. Given the large number of wearable devices that capture physiological signals of the human body easily and noninvasively, several studies have used this equipment to measure the HRV of individuals and related these measures to COVID-19.
The objective of this study was to assess the utility of HRV measurements obtained from wearable devices as predictive indicators of COVID-19, as well as the onset and worsening of symptoms in affected individuals.
A systematic review was conducted searching the following databases up to the end of January 2023: Embase, PubMed, Web of Science, Scopus, and IEEE Xplore. Studies had to include (1) measures of HRV in patients with COVID-19 and (2) measurements involving the use of wearable devices. We also conducted a meta-analysis of these measures to reduce possible biases and increase the statistical power of the primary research.
The main finding 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 that a reduction in HRV parameters is associated with COVID-19. Individuals with COVID-19 presented a reduction in the SD of the normal-to-normal interbeat intervals and root mean square of the successive differences compared with healthy individuals. The decrease in the SD of the normal-to-normal interbeat intervals was 3.25 ms (95% CI -5.34 to -1.16 ms), and the decrease in the root mean square of the successive differences was 1.24 ms (95% CI -3.71 to 1.23 ms).
Wearable devices that measure changes in HRV, such as smartwatches, rings, and bracelets, provide information that allows for the identification of COVID-19 during the presymptomatic period as well as its worsening through an indirect and noninvasive self-diagnosis.
最近的研究表明，心率变异性（HRV）低与 COVID-19 有关，这表明该参数可以作为疾病发作、严重程度的标志物，也是感染人群死亡率的预测指标。鉴于有大量可轻松、无创地采集人体生理信号的可穿戴设备，因此一些研究已经使用该设备来测量个体的 HRV，并将这些测量结果与 COVID-19 相关联。
本研究旨在评估可穿戴设备获得的 HRV 测量值作为 COVID-19 预测指标的效用，以及作为受影响个体症状发作和恶化的预测指标。
我们对截至 2023 年 1 月底的以下数据库进行了系统检索：Embase、PubMed、Web of Science、Scopus 和 IEEE Xplore。研究必须包括（1）COVID-19 患者的 HRV 测量值，以及（2）涉及使用可穿戴设备的测量值。我们还对这些措施进行了荟萃分析，以减少可能的偏倚并提高主要研究的统计效力。
主要发现是 HRV 降低与 COVID-19 症状的发作和恶化之间存在关联。在某些情况下，甚至可以在临床检测呈阳性之前预测 COVID-19 的发作。对报告的研究进行荟萃分析表明，HRV 参数的降低与 COVID-19 有关。与健康个体相比，COVID-19 患者的正常心搏间期标准差和连续心搏间差值均方根降低。正常心搏间期标准差降低 3.25ms（95%CI-5.34 至-1.16ms），连续心搏间差值均方根降低 1.24ms（95%CI-3.71 至 1.23ms）。
可穿戴设备通过测量 HRV 的变化，例如智能手表、戒指和手链，可以提供信息，从而在症状出现前识别 COVID-19，并且可以通过间接的非侵入性自我诊断来监测其恶化情况。
