Utilising the MyHeart Counts smartphone app to determine the impact of COVID-19 on cardiovascular health of patients and healthcare workers

The UK has one of the highest global rates of COVID-19 per capita. The prevalence and manifestation of acute infection and the long-term consequences of COVID-19 on patients with cardiovascular disease, and at-risk healthcare workers remains unclear. As highlighted by the Academy of Medical Sciences a second winter wave is now also a possibility that requires planning for. Recent data from Italy highlight that 87.4% of patients report persistence of at least 1 symptom, and a high proportion of individuals still report cardio-respiratory symptoms such as fatigue, dyspnoea, and chest pain following recovery from COVID-19. UK follow up studies to assess the long-term sequelae of COVID-19 in hospitalised survivors (PHOSP-COVID) are imminent. However, PHOSP-COVID does not include monitoring of non-hospitalised (mild or asymptomatic) COVID-19 cases that are now presenting to clinics with ongoing problems.
Through the Sheffield Teaching Hospitals NHS Foundation Trust (STH) Observational study of pulmonary hypertension, cardiovascular and respiratory diseases study (STH-Obs, REC:18/YH/0441 Chief Investigator - Lawrie) we have ethical approval to remotely monitor participents (including COVID-19), collect blood samples from patients, staff and healthy volunteers, and link their data to hospital records. The MyHeart Counts App, freely available for iOS collects surveys on physical activity and mindset, smoking, risk factors, family history, existing heart and vascular disease, diet, sleep, ethnicity and education, and guides the user through a 6-minute walking test. In addition to these surveys, the App utilises the HealthKit API to acquire data from the Apple Health App allowing analysis of personal activity across the range of heart and vascular diseases. During the recent COVID-19 pandemic, MyHeart Counts was updated to include a fortnightly COVID-19 testing (PCR & serological) and symptom survey. We therefore have the ability to interrogate the impact of COVID-19 on the spectrum of cardiovascular health, and its relationships with cardiovascular disease. Working with MyHeart Counts team we have developed a pipeline to link MyHeart Counts data to our STH-Obs clinical database. Through 2 Apple Investigator awards (In-kind support of 360 Apple Watches), we are currently recruiting patients with cardiovascular disease, and healthcare workers for whom COVID-19 antibody status is known.
We hypothesise that 1) Real-world activity and heart rate/rhythm data will provide early insights into development of, long-term recovery from, and complications due to COVID-19; and 2) Integration of real-world activity and heart rate/rhythm data with biomarkers will provide novel insight in the physical manifestation of, and molecular mechanisms regulating complications post-COVID-19.
To address these hypotheses, we are looking for a motivated PhD candidate with a background in computer science and some experience with Python and R coding to join our team to address the following research questions.
1. Does demographic profile (age, gender, ethnicity, smoking history) influence symptoms and / or severity of COVID-19 (in the hospitalised, or non-hospitalised population)?
2. Are specific cardiovascular diseases (e.g. CAD, AF, HF, PH) associated with prevalence, symptoms / or severity of COVID-19?
3. Does the level of background physical activity influence susceptibility to COVID-19 in patients with cardiovascular disease?
4. Has lockdown affected particular cardiovascular diseases with regard to a) activity, b) perspective of health, c) wellbeing more than others?
5. Does variation in heart rate (e.g. HR reserve) measured via a SmartWatch predict COVID-19 symptoms, severity, recovery? And does this differ between hospitalised vs non-hospitalised individuals?
6. How to biomarkers correlate with cardiovascular health as measured by MyHeart Counts, and COVID-19 symptoms and severity.