Deploying remote monitoring has been a steadily more viable option in recent years as the technology improves and analyzing the data becomes more practical. One way to digest and share this option is the use of AI, which if deployed effectively can automate the analytical process and even recommend clinical options for treating these patients.
In this spirit, a company that uses AI for cardiac diagnostics is launching a study to determine the effectiveness of monitoring the cardiac health of COVID-19 patients being treated with hydroxychloroquine.
The company, Cardiologs, is using ECG data collected from smartwatches to conduct this study. It will be monitoring patients for signs of QT prolongation, a sign found on ECGs which is associated with severe cardiac arrhythmias.
The trial will study patients infected with COVID-19 at the University Hospital of Marseille in France. The subjects being studied are being treated with a combination of azithromycin and hydroxychloroquine. Particularly when used together, they are prone to causing QT prolongation as a side effect, which leads to increased concerns about patients experiencing ventricular arrhythmia and death.
Patients participating in the study will get a Withings Move ECG Watch linked to the Cardiologs AI platform, which is FDA cleared for QT interval analysis and arrhythmia diagnostics. Over the course of a 10-day course of treatment, the smartwatch will send daily ECG readings to the Cardiologs AI platform. Researchers will then compare the data to traditional ECG measures. The data will be used to assess drug-induced cardiotoxic risk along with arrhythmic events.
Right now, ECG monitoring of patient QT intervals is the current standard of care to keep patients maintain cardiac safety in clinical settings. However, the emergence of COVID-19 has made it difficult for providers to address this problem as they have in the past, the company’s statement notes.
As the company points out, it’s difficult to monitor COVID-19 patients using traditional ECG technology, For one thing, conducting ECGs risks providers becoming infected or passing on the virus passively. Not only that, it’s unlikely that hospitals would be able to monitor the growing population of infected patients over a short time given limits on hospital resources. Under these circumstances, smartwatches might offer a viable alternative, researchers said.
“Smartwatches are already used in the clinical setting but do not have validated QT analysis available,” said Professor Jean-Claude Deharo, head of the cardiac arrhythmia department at the University Hospital of Marseille and principal investigator of the study. “[This approach] will enable clinicians to overcome practical limitations in the context of COVID-19 of the standard patient safety strategy that requires heavy patient interaction.”
According to Professor Jag Singh, Professor of Medicine at Harvard Medical School and a scientific advisor to Cardiologs, studying the potential could have long-term benefits, particularly when it comes to managing the risk of drug-induced cardiotoxicity. “Personal ECG sensors could potentially find a role in the management of these patients but also add value in other routing clinical care, since over 300 commonly used drugs may have similar QT-prolongation risks as hydroxychloroquine.”
Folks, if I were a COVID-19 patient, I wouldn’t be too comforted by the word “potentially” in Dr. Singh’s comments. There are also ethics questions related to whether it’s acceptable to test an unproven technology on patients who could be at a high risk of death.
Also, it’s worth bearing in mind that while the Cardiologs platform is FDA cleared, the Withings smartwatches are not (though they do bear the CE mark, a standard used in the EU certifies that it meets health, safety, and environmental protection standards).
All told, the study may offer useful insights into how to use smartwatches during the war against COVID-19. However, it remains to be seen whether using such devices is worth the risk under normal circumstances.