scholarly journals Early Detection of Symptom Exacerbation in Patients With SARS-CoV-2 Infection Using the Fitbit Charge 3 (DEXTERITY): Pilot Evaluation (Preprint)

2021 ◽  
Author(s):  
Kan Yamagami ◽  
Akihiro Nomura ◽  
Mitsuhiro Kometani ◽  
Masaya Shimojima ◽  
Kenji Sakata ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Early Stage ◽  
Sleep Apnea Syndrome ◽  
Wearable Device ◽  
University Hospital ◽  
Polymerase Chain Reaction Test ◽  
Biometric Data ◽  
Phone Calls ◽  
Obstructive Sleep ◽  
Symptom Exacerbation

BACKGROUND Some patients with COVID-19 experienced sudden death due to rapid symptom deterioration. Thus, it is important to predict COVID-19 symptom exacerbation at an early stage prior to increasing severity in patients. Patients with COVID-19 could experience a unique “silent hypoxia” at an early stage of the infection when they are apparently asymptomatic, but with rather low SpO<sub>2</sub> (oxygen saturation) levels. In order to continuously monitor SpO<sub>2</sub> in daily life, a high-performance wearable device, such as the Apple Watch or Fitbit, has become commercially available to monitor several biometric data including steps, resting heart rate (RHR), physical activity, sleep quality, and estimated oxygen variation (EOV). OBJECTIVE This study aimed to test whether EOV measured by the wearable device Fitbit can predict COVID-19 symptom exacerbation. METHODS We recruited patients with COVID-19 from August to November 2020. Patients were asked to wear the Fitbit for 30 days, and biometric data including EOV and RHR were extracted. EOV is a relative physiological measure that reflects users’ SpO<sub>2</sub> levels during sleep. We defined a high EOV signal as a patient’s oxygen level exhibiting a significant dip and recovery within the index period, and a high RHR signal as daily RHR exceeding 5 beats per day compared with the minimum RHR of each patient in the study period. We defined successful prediction as the appearance of those signals within 2 days before the onset of the primary outcome. The primary outcome was the composite of deaths of all causes, use of extracorporeal membrane oxygenation, use of mechanical ventilation, oxygenation, and exacerbation of COVID-19 symptoms, irrespective of readmission. We also assessed each outcome individually as secondary outcomes. We made weekly phone calls to discharged patients to check on their symptoms. RESULTS We enrolled 23 patients with COVID-19 diagnosed by a positive SARS-CoV-2 polymerase chain reaction test. The patients had a mean age of 50.9 (SD 20) years, and 70% (n=16) were female. Each patient wore the Fitbit for 30 days. COVID-19 symptom exacerbation occurred in 6 (26%) patients. We were successful in predicting exacerbation using EOV signals in 4 out of 5 cases (sensitivity=80%, specificity=90%), whereas the sensitivity and specificity of high RHR signals were 50% and 80%, respectively, both lower than those of high EOV signals. Coincidental obstructive sleep apnea syndrome confirmed by polysomnography was detected in 1 patient via consistently high EOV signals. CONCLUSIONS This pilot study successfully detected early COVID-19 symptom exacerbation by measuring EOV, which may help to identify the early signs of COVID-19 exacerbation. CLINICALTRIAL University Hospital Medical Information Network Clinical Trials Registry UMIN000041421; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000047290

scholarly journals Early Detection of Exacerbation of the Severe Acute Respiratory Syndrome Coronavirus 2 Infection using Fitbit (DEXTERITY Pilot Study)

2021 ◽  
Author(s):  
Kan Yamagami ◽  
Akihiro Nomura ◽  
Mitsuhiro Kometani ◽  
Masaya Shimojima ◽  
Kenji Sakata ◽  
...  
Keyword(s):  
Pilot Study ◽  
Sleep Apnea Syndrome ◽  
Blood Oxygen ◽  
Chain Reaction ◽  
Blood Oxygen Saturation ◽  
Oxygen Saturation Level ◽  
Early Signs ◽  
Obstructive Sleep ◽  
Symptom Exacerbation ◽  
Polymerase Chain

Abstract Some patients with coronavirus disease 2019 (COVID-19) experienced sudden death because of sudden symptom deterioration. Thus, an alarm system that could detect early signs of COVID-19 exacerbation beforehand, to prevent serious illness or death of patients while receiving outpatient treatment at home or in hotels is necessary. Here, we tested whether estimated oxygen variations (EOV), a relative physiological scale that represents users’ blood oxygen saturation level during sleep measured by Fitbit, predicted COVID-19 symptom exacerbation. Study period was from August to November 2020. We enrolled 23 COVID-19 patients diagnosed by SARS-CoV-2 polymerase chain reaction-positive (mean age ± standard deviation, 50.9 ± 20 years; 70% female), let each patient wore the Fitbit for 30 days; COVID-19 symptoms were exacerbated in 6 (26%). High EOV signal (a patient’s oxygen level exhibits significant dip and recovery within the index period) had 80% sensitivity before symptom exacerbations, whereas resting heart rate signal only had 50% sensitivity. Coincidental obstructive sleep apnea syndrome confirmed by polysomnography was detected in a patient by consistently high EOV signals. This pilot study successfully detected early COVID-19 symptoms exacerbation by measuring EOV and may help to identify early signs of COVID-19 exacerbation.

scholarly journals Daytime Sleepiness Among Young Adult Omani Car Drivers

2018 ◽  
Vol 18 (2) ◽  
pp. 143 ◽  
Author(s):  
Mohammed A. Al-Abri ◽  
Samir Al-Adawi ◽  
Ibrahim Al-Abri ◽  
Faisal Al-Abri ◽  
Atsu Dorvlo ◽  
...  
Keyword(s):  
Young Adult ◽  
Sleep Duration ◽  
Daytime Sleepiness ◽  
Sleep Apnea Syndrome ◽  
University Hospital ◽  
Motor Vehicles ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Berlin Questionnaire ◽  
Nocturnal Sleep ◽  
Obstructive Sleep

Objectives: Sleepiness and fatigue play significant roles in exacerbating the occurrence of car crashes. However, there is a dearth of studies examining the prevalence of sleepiness while driving among Omanis. This study aimedto determine the proportion of young Omani adults who confess to daytime sleepiness while driving and to investigate associations between gender, daytime sleepiness and risk of obstructive sleep apnoea syndrome (OSAS). Methods: This cross-sectional study took place at the Sultan Qaboos University Hospital, Muscat, Oman, between May and July 2014 and included 600 young adult Omani non-commercial drivers. The Berlin Questionnaire and Epworth Sleepiness Scale (ESS) were distributed among the participants, along with additional questions about their sleeping habits. Associations between daytime sleepiness while driving and nocturnal sleep duration, risk of OSAS and gender were determined. Results: A total of 492 private vehicle drivers took part in the study (response rate: 82%), of which 50.4% were male. Overall, 124 Omanis (25.2%) reported experiencing daytime sleepiness while driving at least once per month. There was a significant association between nocturnal sleep duration of <6 hours and sleepiness while driving (P = 0.042). Female participants were significantly more likely to score >10 on the ESS, indicating a greater propensity for daytime sleepiness (P = 0.006). However, male drivers were significantly more likely to report sleepiness while driving (P = 0.001). Conclusion: Sleepiness while driving was common among young male drivers in Oman and might be due to nocturnal sleep deprivation. Further studies are needed so that preventative measures can be developed.Keywords: Motor Vehicles; Traffic Accidents; Sleep; Fatigue; Obstructive Sleep Apnea Syndrome; Oman.

scholarly journals Baseline Fgf23 is Associated with Cardiovascular Outcome in Incident Pd Patients

2016 ◽  
Vol 36 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Hyo Jin Kim ◽  
Miseon Park ◽  
Hayne Cho Park ◽  
Jong Cheol Jeong ◽  
Dong Ki Kim ◽  
...  
Keyword(s):  
Cerebrovascular Disease ◽  
Subgroup Analysis ◽  
Primary Outcome ◽  
Early Stage ◽  
Fibroblast Growth Factor 23 ◽  
Left Ventricular ◽  
University Hospital ◽  
Baseline Serum ◽  
All Cause Mortality

♦ BackgroundFibroblast growth factor 23 (FGF23) is a phosphate regulating protein. Several studies demonstrated that elevated FGF23 is independently associated with mortality for early-stage chronic kidney disease and incident hemodialysis (HD) patients. However, little is known about the significance of elevated FGF23 in peritoneal dialysis (PD) patients. Here, we analyzed the association of FGF23 with cardiovascular (CV) events, all-cause mortality, residual renal function (RRF), and CV parameters in PD patients.♦ MethodsThe present study is a single-center, retrospective study. Patients who started PD at Seoul National University Hospital between January 2005 and July 2011 and whose baseline serum samples were available were enrolled. C-terminal FGF23 was measured. Subjects were divided into 2 groups; lower 2 tertiles (FGF23 ≤ 119.0 RU/mL) and top tertile (FGF23 > 119.0 RU/mL). The primary outcome was time to fatal or non-fatal CV events. In the subgroup analysis, the associations of FGF23 with aortic stiffness or with vascular calcification were analyzed.♦ResultsA total of 205 incident PD patients were analyzed. Mean duration of follow-up was 41.6 ± 20.0 months. The baseline median FGF23 level was 78.6 RU/mL (interquartile range [IQR], 34.1 – 155.0). At baseline, subjects in the higher FGF23 group were younger, and had a lower RRF, lower prevalence of diabetes mellitus (DM), and cerebrovascular disease. During follow-up, 22 of the 205 patients (10.7%) reached primary outcome. After adjustment for age, DM, pre-existing coronary artery disease, cerebrovascular disease, congestive heart failure, and left ventricular mass index, the higher FGF23 group exhibited significantly higher risk of primary outcome, compared with the lower group (hazard ratio [HR], 2.54; 95% confidence interval [CI], 1.05 – 6.12; p = 0.045). There were no significant differences in all-cause mortality and development of anuria between the 2 FGF23 groups. In the subgroup analysis, FGF23 groups were not associated with pulse wave velocity and abdominal aortic calcification score.♦ ConclusionElevated FGF23 is associated with higher risk of adverse CV outcome for incident PD patients.

scholarly journals Assessment of the Effectiveness of Obstructive Sleep Apnea Treatment Using Optical Coherence Tomography to Evaluate Retinal Findings

2021 ◽  
Author(s):  
Gloria Tejero-Garcés ◽  
Francisco J Ascaso ◽  
Paula Casas ◽  
Maria I Adiego ◽  
Peter Baptista ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Optical Coherence Tomography ◽  
Sleep Apnea ◽  
Retinal Thickness ◽  
Sleep Apnea Syndrome ◽  
University Hospital ◽  
Optical Coherence ◽  
Fiber Layer ◽  
Obstructive Sleep ◽  
Prospective Comparative Study

Retinal findings may change in patients with obstructive sleep apnea syndrome (OSAS). The present study aims to evaluate several retinal findings such as macula layer thickness, peripapillary retinal nerve fiber layer, and the optic nerve head in patients with OSAS using optical coherence tomography (OCT) and monitor the result of several types of treatment of OSAS with OCT. A prospective comparative study was designed. Patients were recruited at a Sleep Unit of a University Hospital and underwent comprehensive ophthalmological examinations. Following exclusion criteria, fifty-two patients with OSAS were finally included. Patients were examined by OCT twice: first, before treatment; secondly, after six months of treatment. In mild-moderate patients, where retinal swelling has been demonstrated, retinal thicknesses decreased [fovea (p=0.026), as well as inner ring macula (p=0.007), outer ring macula (p=0.015), and macular volume (p=0.015)]. In severe patients, where retinal atrophy had been observed, retinal thickness increased [fovea (p&amp;lt;0.001)]. No statistically significant differences in efficacy between treatments were demonstrated. In conclusion, OCT can evaluate the retina in patients with OSAS and help monitor results after treatment. In severe OSAS, retinal thickness increased six months after treatment.

scholarly journals High prevalence of obstructive sleep apnea syndrome in Spain’s Stroke Belt

2021 ◽  
Vol 49 (10) ◽  
pp. 030006052110530
Author(s):  
Ana Domínguez-Mayoral ◽  
Jesús Sánchez-Gómez ◽  
Patricia Guerrero ◽  
Marta Ferrer ◽  
Carmen Gutiérrez ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Central Sleep Apnea ◽  
University Hospital ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
High Prevalence ◽  
Apnea Syndrome ◽  
Stroke Belt

Objective Spain’s so-called Stroke Belt is an area with high prevalence of vascular disease. We aimed to determine the prevalence of undetected obstructive sleep apnea–hypopnea syndrome (OSAHS) among patients with acute ischemic stroke (AIS) in southern Spain. Methods We conducted a cross-sectional study at the Virgen Macarena University Hospital Stroke Unit during 2018 to 2019. We included patients <72 hours after AIS with a neuroimaging lesion and performed sleep tests. Results Seventy-two patients were included. The median participant age was 72 years. Mean body mass index was 27.07 kg/m2, and 40.28% were daily alcohol drinkers. Hypertension, atrial fibrillation, ischemic cardiomyopathy, and previous stroke were detected in 63.9%, 11.1%, 15.3%, and 17.6% of patients, respectively. Polygraphy was feasible in 91.38% of patients. The prevalence of OSAHS was 84.72% (apnea–hypopnea index ≥5). Patients with moderate and severe OSAHS were more likely to be obese and to have a larger neck circumference and facial palsy. The diagnostic criteria of central sleep apnea syndrome were met in only 1.38% of patients. Conclusions The high prevalence of OSAHS found in the Spanish Stroke Belt justifies further investigation and development of a screening program as a strategy to identify patients with undetected OSAHS.

scholarly journals PATIENTS PROFILE AT THE SLEEP APNEA OUTPATIENT CLINIC AT A UNIVERSITY HOSPITAL

2020 ◽  
Vol 11 (1) ◽  
pp. 23-30
Author(s):  
Natania Tuanny Damasceno Inácio ◽  
Juliane Patrícia Grigório da Silva ◽  
Lidiane Maria de Brito Macedo Ferreira ◽  
Alexandre Augusto Fernandes
Keyword(s):  
Sleep Apnea ◽  
Outpatient Clinic ◽  
Medical Records ◽  
Sleep Apnea Syndrome ◽  
Substantial Reduction ◽  
University Hospital ◽  
Cross Sectional ◽  
Group I ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Introduction: Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent collapses of the pharyngeal region during sleep, resulting in a substantial reduction in airflow (apnea and hypopnea), despite respiratory efforts. Objective: To report the profile of patients referred to the Sleep Apnea Outpatient Clinic of Hospital Universitário Onofre Lopes (HUOL), emphasizing on the main risk factors associated with OSAS. Methodology: It is retrospective study, cross-sectional, in which data obtained by reviewing medical records of patients seen at the sleep apnea outpatient clinic between 2017 and 2019 were used. Results: Medical records of 43 patients were evaluated, being (62, 8%) male and (37.2%) female. All patients underwent previous screening before polysomnography, being divided into three groups: Group I - with mild OSAS: 8 patients (18.6%); Group II - with moderate OSAS: 18 patients (41.8%); Group III - with severe OSAS: 17 patients (39.5%). Conclusion: Sleep apnea syndrome is commonly correlated with metabolic syndrome.

Postoperative monitoring of children with obstructive sleep apnea syndrome

2014 ◽  
Vol 155 (18) ◽  
pp. 703-707 ◽  
Author(s):  
Pálma Benedek ◽  
Gabriella Kiss ◽  
Eszter Csábi ◽  
Gábor Katona
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Preoperative Evaluation ◽  
Sleep Apnea Syndrome ◽  
Study Patient ◽  
Severe Obstructive Sleep Apnea ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Apnea Syndrome

Introduction: Treatment of pediatric obstructive sleep apnea syndrome is surgical. The incidence of postoperative respiratory complications in this population is 5–25%. Aim: The aim of the authors was to present the preoperative evaluation and monitoring procedure elaborated in Heim Pál Children Hospital, Budapest. Method: 142 patients were involved in the study. Patient history was obtained and physical examination was performed in all cases. Thereafter, polysomnography was carried out, the severity of the obstructive sleep apnea syndrome was determined, and the patients underwent tonsilloadenotomy. Results: 45 patients with mild, 50 patients with moderate and 47 patients with severe obstructive sleep apnea syndrome were diagnosed. There was no complication in patients with mild disease, while complications were observed in 6 patients in the moderate group and 24 patients in the severe group (desaturation, apnea, stridor, stop breathing) (p<0.000). In patients with severe obstructive sleep apnea syndrome, no significant difference was noted in preoperative apnoea-hypapnea index (p = 0.23) and in nadir oxygen saturation values (p = 0.73) between patients with and without complication. Conclusions: Patients with severe obstructive sleep apnea syndrome should be treated in hospital where pediatric intensive care unit is available. Orv. Hetil., 2014, 155(18), 703–707.

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