Feasibility of remote home monitoring with a T-shirt wearable device in post-recovery COVID-19 patients

Background and Aim of the Study: During the last months, a pandemic by a novel coronavirus (Sars-Cov-2) has spread worldwide, putting hospitals under enormous pressure. Although follow-up data in this setting are scarce, early reports suggested that more than 80% of patients who had recovered from COronaVIrus Disease 19 (COVID-19) reported persistence of at least one symptom during follow-up, particularly fatigue and dyspnea. Therefore, a prolonged post-discharge monitoring for long-lasting effects is advisable. We assessed the feasibility of cardiorespiratory home monitoring through a wearable device in post-COVID-19 patients. Methods: in this pilot study, we enrolled subjects with a confirmed diagnosis of COVID-19 after hospital discharge at home. A wearable device used (L.I.F.E.) (a technologically advanced T-Shirt device composed of ink-based dry electrodes linked to standard 12-lead ECG monitoring, 5 respiratory strain sensors, 1 accelerometer, a digital pulse oximeter) was used (Figure 1). Monitoring was carried out for at least 7 days and comprehended a two-hour monitoring period a day during rest and a short exercise (6 minutes of brisk walking) and an overnight sleep monitoring on the last day. Results: Seventeen COVID-19 patients (male 8;age 54.4±15.3 year old;BMI 25.1±3.1) were enrolled at hospital discharge. They underwent 12.5±2.5 (7-17) days of monitoring. Clinical characteristics of the population and data monitoring are shown in Figure 2. Twelve patients (70.6%) performed the nighttime monitoring. Among them, one showed an apnea-hypopnea index (AHI) of 20, suggestive of moderate sleep apnea syndrome. An example of ECG monitoring is shown in Figure 3. Conclusions: Our study demonstrated that a post-discharge home monitoring program for COVID-19 patients is feasible and safe. The L.I.F.E. T-Shirt device was able to collect a full set of cardiorespiratory parameters (i.e. heart rate, a full ECG, respiratory rate, SpO2), both at rest and during a brief exercise. Finally, we were able to identify only one patient without any previous disease who presented post-COVID sleep apnea syndrome. Further studies are certainly needed to assess the prevalence and the clinical impact of this complication in post-COVID-19 patients.