A new study from researchers at the University of South Australia reveals that wearable activity trackers, such as Apple Watches and Fitbits, show promise in detecting early signals of disease—particularly atrial fibrillation associated with stroke and COVID-19. The study is published in the journal JMIR mHealth and uHealth.

Wearable devices can track steps, hours slept, and blood pressure, heart rate, oxygen levels, and skin temperature, as well as falls, the authors explain. In a review of 28 studies on these devices, 16 studies (57%) used wearables for diagnosis of COVID-19, 5 studies (18%) for atrial fibrillation, 3 studies (11%) for arrhythmia or abnormal pulse, 3 studies (11%) for falls, and 1  study (4%) for viral symptoms.

For COVID-19 diagnosis, wearables were accurate 87.5% of the time (95% confidence interval [CI], 81.6% to 93.5%), with a sensitivity of 79.5% (95% CI, 67.7% to 91.3%), and a specificity of 76.8% (95% CI, 69.4% to 84.1%). The authors said the wearables were as accurate as rapid antigen tests, or lateral flow devices. 

As sensitive as clinical testing 

Even more encouraging were the findings concerning atrial fibrillation: "The sensitivity and specificity of a 12-lead electrocardiogram for detecting atrial fibrillation have previously been shown to range between 93% and 97%, which appears similar to our sensitivity and specificity of 94.2% and 95.3%, respectively," the authors wrote. 

For atrial fibrillation detection, pooled positive predictive value was 87.4% (95% CI, 75.7% to 99.1%), sensitivity was 94.2% (95% CI, 88.7% to 99.7%), and specificity was 95.3% (95% CI, 91.8% to 98.8%).

Our systematic review shows that wearable activity trackers like Fitbits and Apple Watches have significant promise in detecting COVID-19 and heart conditions in real-world settings.

"Our systematic review shows that wearable activity trackers like Fitbits and Apple Watches have significant promise in detecting COVID-19 and heart conditions in real-world settings, which has the potential to improve personal health monitoring," said lead author Ben Singh, PhD, MPH, in a press release from the University of South Australia. 

A study of children who receive a tracheostomy and long-term home ventilation (HV) reveals that 75% get vaccinated against influenza, but of the 53% who complete their initial COVID-19 vaccine series, only 23% receive the recommended boosters.

A Boston Children's Hospital–led research team collected tracheal aspirates from 193 children on long-term HV and eligible for vaccination and conducted caregiver interviews to determine the cause of acute respiratory infections (ARIs) and to document flu and COVID-19 vaccination status from March 2022 to October 2023. 

The children were seen at 13 centers in 12 states and Washington, DC, participating in the Multicenter Tracheostomy Collaboration. The median patient age was 10.5 years, the median age at tracheostomy was 6.0 months, and 63% were boys.

The authors noted that children receiving HV are at high risk for ARI infection and death. The Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend that all children aged 6 months and older receive annual flu and COVID-19 vaccines.

"Concern, however, exists that growing antivaccination sentiments, emerging 'medical freedom movements,' and specific mistrust of COVID-19 vaccines may negatively affect rates of vaccination among children at high risk," they wrote.

Discordance between access, uptake

"Compared with immunization status overall among US children aged younger than 18 years, our cohort had higher adherence to influenza vaccination (75% vs 50%), similar rates of initial COVID-19 vaccination (53% vs 50%), and much lower rates of receiving a COVID-19 booster (23% vs 50%)," the researchers wrote. 

Concern... exists that growing antivaccination sentiments, emerging 'medical freedom movements,' and specific mistrust of COVID-19 vaccines may negatively affect rates of vaccination among children at high risk.

Of participants given an annual flu vaccine, 61% also received a COVID vaccine. Among the 18% of patients never given a flu vaccine, 17% received a COVID vaccine.

A multivariable analysis showed that participants with a significantly higher likelihood of receiving a COVID vaccine were older (odds ratio [OR], 1.14) and previously vaccinated against the flu (OR, 8.93).

The authors said that families' engagement with the healthcare system suggests that they had access to screening, education, and vaccination, highlighting the need for qualitative studies on COVID vaccine resistance.