The illness caused by the new coronavirus, SARS-CoV-2, can be roughly divided into two stages. During the first stage, in which symptoms are not acute, infected individuals can generally remain at home. In serious cases, this is followed by a second stage with worsening symptoms in which some patients develop severe pneumonia. "In these cases, patients must be admitted to a hospital as quickly as possible. The sooner they receive good medical treatment, the better the prognosis," explains Prof. Georg Schmidt, the head of the Biosignal Analysis Working Group at TUM’s university hospital Klinikum rechts der Isar.
Prof. Schmidt and his team now want to assess whether a high-tech solution – specifically, an in-ear wearable sensor – can speed up the detection of worsening symptoms in COVID-19 patients. They also hope that prompt treatment will ease the workload of intensive care units by eliminating the need for intensive treatment, including mechanical ventilation, in some cases.
Timely intervention in case of deteriorating symptoms
Persons infected with COVID-19 in Munich are currently contacted by the city's Department of Health and Environment (RGU) as soon as possible after test results are available. RGU asks patients about their health status via telephone every day and offers advice. Anyone who is tested positive can contact a 24-hour telephone service organized by RGU in the event of symptoms, which will come to their home if necessary and organize transport to hospital if necessary. To date, only around 13% of those infected develop severe symptoms and require inpatient treatment.
“Currently, first-stage patients are instructed to take their temperature at home, engage in self-monitoring and to call the health department or their family doctor in case of certain symptoms,” explains Georg Schmidt. “This harbors various uncertainties: The temperature must be measured accurately, the patient has to decide whether to contact a doctor and a decision has to be made whether to admit them to hospital. This can result in delays. We hope that with continuous telemonitoring of biodata and a rapid response when the patient's condition worsens, we can significantly improve the prognosis.”
In-ear-sensors instead of smartwatches
Along with core body temperature, the monitoring will include the patient's blood oxygen saturation, respiration rate and pulse. A composite score, or “polyscore”, will also be calculated several times a day. This indicates how well the body is compensating for the effects of the disease.
Prof. Schmidt has been cooperating with cosinuss, a Munich-based start-up that originated with a doctoral thesis topic at TUM, for some time. The company's in-ear wearable sensors use optical processes, among other technologies, to capture biodata. “These devices can measure all of the parameters we need and transmit them to a small computer via a Bluetooth connection. From there they are forwarded to our central office for analysis in compliance with data protection regulations,” says Georg Schmidt. “A study that we conducted a few months ago on another topic showed that the elderly in particular are at ease with these sensors.”
The success of the current study will depend to a large extent on the close cooperation of various parties. Possible participants – COVID-19 patients over 60 years of age living in home isolation in Munich – will be identified through the Munich Department of Environment and Health and can volunteer for participation. Under a doctor's supervision, a team of specially trained medical students in a “control center” at Klinikum rechts der Isar will track the monitored data around the clock. Patients will be reported directly to first responders in case the data, checked against pre-defined parameters, indicate that their condition is deteriorating. This will ensure that they can be transported to a hospital without delay.