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Addleman JS, Lackey NS, DeBlauw JA, Hajduczok AG. Heart Rate Variability Applications in Strength and Conditioning: A Narrative Review. J Funct Morphol Kinesiol 2024; 9:93. [PMID: 38921629 PMCID: PMC11204851 DOI: 10.3390/jfmk9020093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/27/2024] Open
Abstract
Heart rate variability (HRV) is defined as the fluctuation of time intervals between adjacent heartbeats and is commonly used as a surrogate measure of autonomic function. HRV has become an increasingly measured variable by wearable technology for use in fitness and sport applications. However, with its increased use, a gap has arisen between the research and the application of this technology in strength and conditioning. The goal of this narrative literature review is to discuss current evidence and propose preliminary guidelines regarding the application of HRV in strength and conditioning. A literature review was conducted searching for HRV and strength and conditioning, aiming to focus on studies with time-domain measurements. Studies suggest that HRV is a helpful metric to assess training status, adaptability, and recovery after a training program. Although reduced HRV may be a sign of overreaching and/or overtraining syndrome, it may not be a sensitive marker in aerobic-trained athletes and therefore has different utilities for different athletic populations. There is likely utility to HRV-guided programming compared to predefined programming in several types of training. Evidence-based preliminary guidelines for the application of HRV in strength and conditioning are discussed. This is an evolving area of research, and more data are needed to evaluate the best practices for applying HRV in strength and conditioning.
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Affiliation(s)
- Jennifer S. Addleman
- College of Osteopathic Medicine, Touro University California, Vallejo, CA 94592, USA
| | - Nicholas S. Lackey
- Center for Applied Biobehavioral Sciences (CABS), Alliant International University, San Diego, CA 92131, USA;
| | - Justin A. DeBlauw
- Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY 12866, USA
| | - Alexander G. Hajduczok
- Department of Cardiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA;
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2
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Wong KC, Kuo CY, Tzeng IS, Hsu CF, Wu CW. The COVIDTW2 study: Role of COVID-19 vaccination in intubated patients with COVID-19-related acute respiratory distress syndrome in Taiwan. J Infect Chemother 2024; 30:393-399. [PMID: 37972691 DOI: 10.1016/j.jiac.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/01/2023] [Accepted: 11/12/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND COVID-19 vaccines have reduced the risk of disease progression to respiratory failure or death. However, in patients with breakthrough infections requiring invasive mechanical ventilation, the effect of prior COVID-19 vaccination on mortality remains inconclusive. METHOD We retrospectively analyzed data on patients intubated due to COVID-19 pneumonia between May 1, 2022 and October 31, 2022. Receipt of two or more doses of vaccine were considered as fully vaccinated. The primary outcome was the time from intubation to all-cause intensive care unit (ICU) mortality. RESULT A total of 84 patients were included (40 fully vaccinated versus 44 controls). The baseline characteristics, including age, comorbidities, and Sequential Organ Failure Assessment (SOFA) score on the day of intubation were similar between the two groups. The difference in ICU mortality rate between the fully vaccinated and control groups was not significant (35 % vs. 25 %, P = 0.317; hazard ratio with 95 % confidence interval = 1.246 (0.575-2.666), P = 0.571). The SOFA score (hazard ratio: 1.319, P = 0.001) and body mass index (BMI) (hazard ratio: 0.883, P = 0.022) were significantly associated with ICU mortality. CONCLUSION Being fully vaccinated was not associated with a mortality benefit in intubated patients with COVID-19. A higher SOFA score on the day of intubation and lower BMI were poor prognostic factors.
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Affiliation(s)
- Kuan-Chun Wong
- Department of Pharmacy, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
| | - Chan-Yen Kuo
- Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
| | - I-Shiang Tzeng
- Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
| | - Ching-Fen Hsu
- Department of Family Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
| | - Chih-Wei Wu
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
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Levi Y, Brandeau ML, Shmueli E, Yamin D. Prediction and detection of side effects severity following COVID-19 and influenza vaccinations: utilizing smartwatches and smartphones. Sci Rep 2024; 14:6012. [PMID: 38472345 DOI: 10.1038/s41598-024-56561-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/07/2024] [Indexed: 03/14/2024] Open
Abstract
Vaccines stand out as one of the most effective tools in our arsenal for reducing morbidity and mortality. Nonetheless, public hesitancy towards vaccination often stems from concerns about potential side effects, which can vary from person to person. As of now, there are no automated systems available to proactively warn against potential side effects or gauge their severity following vaccination. We have developed machine learning (ML) models designed to predict and detect the severity of post-vaccination side effects. Our study involved 2111 participants who had received at least one dose of either a COVID-19 or influenza vaccine. Each participant was equipped with a Garmin Vivosmart 4 smartwatch and was required to complete a daily self-reported questionnaire regarding local and systemic reactions through a dedicated mobile application. Our XGBoost models yielded an area under the receiver operating characteristic curve (AUROC) of 0.69 and 0.74 in predicting and detecting moderate to severe side effects, respectively. These predictions were primarily based on variables such as vaccine type (influenza vs. COVID-19), the individual's history of side effects from previous vaccines, and specific data collected from the smartwatches prior to vaccine administration, including resting heart rate, heart rate, and heart rate variability. In conclusion, our findings suggest that wearable devices can provide an objective and continuous method for predicting and monitoring moderate to severe vaccine side effects. This technology has the potential to improve clinical trials by automating the classification of vaccine severity.
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Affiliation(s)
- Yosi Levi
- Department of Industrial Engineering, Tel-Aviv University, Tel-Aviv, Israel
| | - Margaret L Brandeau
- Department of Management Science and Engineering, Stanford University, Stanford, CA, USA
| | - Erez Shmueli
- Department of Industrial Engineering, Tel-Aviv University, Tel-Aviv, Israel
- MIT Media Lab, Cambridge, MA, USA
| | - Dan Yamin
- Department of Industrial Engineering, Tel-Aviv University, Tel-Aviv, Israel.
- Department of Management Science and Engineering, Stanford University, Stanford, CA, USA.
- Center for Combatting Pandemics, Tel-Aviv University, Tel-Aviv, Israel.
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4
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Izuhara M, Matsui K, Yoshiike T, Kawamura A, Utsumi T, Nagao K, Tsuru A, Otsuki R, Kitamura S, Kuriyama K. Association between sleep duration and antibody acquisition after mRNA vaccination against SARS-CoV-2. Front Immunol 2023; 14:1242302. [PMID: 38149250 PMCID: PMC10750410 DOI: 10.3389/fimmu.2023.1242302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/16/2023] [Indexed: 12/28/2023] Open
Abstract
Introduction Sleep enhances the antibody response to vaccination, but the relationship between sleep and mRNA vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is not fully understood. Methods In this prospective observational study, we investigated the influence of sleep habits on immune acquisition induced by mRNA vaccines against SARS-CoV-2 in 48 healthy adults (BNT-162b2, n=34; mRNA-1273, n=14; female, n=30, 62.5%; male, n=18, 37.5%; median age, 39.5 years; interquartile range, 33.0-44.0 years) from June 2021 to January 2022. The study measured sleep duration using actigraphy and sleep diaries, which covered the periods of the initial and booster vaccinations. Results Multivariable linear regression analysis showed that actigraphy-measured objective sleep duration 3 and 7 days after the booster vaccination was independently and significantly correlated with higher antibody titers (B=0.003; 95% confidence interval, 0.000-0.005; Beta=0.337; p=0.02), even after controlling for covariates, including age, sex, the type of vaccine, and reactogenicity to the vaccination. Associations between acquired antibody titer and average objective sleep duration before vaccination, and any period of subjective sleep duration measured by sleep diary were negligible. Discussion Longer objective, but not subjective, sleep duration after booster vaccination enhances antibody response. Hence, encouraging citizens to sleep longer after mRNA vaccination, especially after a booster dose, may increase protection against SARS-CoV-2. Study registration This study is registered at the University Hospital Medical Information Network Center (UMIN: https://www.umin.ac.jp) on July 30, 2021, #UMIN000045009.
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Affiliation(s)
- Muneto Izuhara
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kentaro Matsui
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Takuya Yoshiike
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Aoi Kawamura
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Tomohiro Utsumi
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Department of Psychiatry, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Kentaro Nagao
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Ayumi Tsuru
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Rei Otsuki
- Department of Psychiatry, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Shingo Kitamura
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kenichi Kuriyama
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
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Rastmanesh R, Krishnia L, Kashyap MK. The Influence of COVID-19 in Endocrine Research: Critical Overview, Methodological Implications and a Guideline for Future Designs. Clin Med Insights Endocrinol Diabetes 2023; 16:11795514231189073. [PMID: 37529301 PMCID: PMC10387761 DOI: 10.1177/11795514231189073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 06/14/2023] [Indexed: 08/03/2023] Open
Abstract
The COVID-19 pandemic has changed many aspects of people's lives, including not only individual social behavior, healthcare procedures, and altered physiological and pathophysiological responses. As a result, some medical studies may be influenced by one or more hidden factors brought about by the COVID-19 pandemic. Using the literature review method, we are briefly discussing the studies that are confounded by COVID-19 and facemask-induced partiality and how these factors can be further complicated with other confounding variables. Facemask wearing has been reported to produce partiality in studies of ophthalmology (particularly dry eye and related ocular diseases), sleep studies, cognitive studies (such as emotion-recognition accuracy research, etc.), and gender-influenced studies, to mention a few. There is a possibility that some other COVID-19 related influences remain unrecognized in medical research. To account for heterogeneity, current and future studies need to consider the severity of the initial illness (such as diabetes, other endocrine disorders), and COVID-19 infection, the timing of analysis, or the presence of a control group. Face mask-induced influences may confound the results of diabetes studies in many ways.
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Affiliation(s)
| | - Lucky Krishnia
- Amity Centre of Nanotechnology, Amity University Haryana, Panchgaon, Haryana, India
| | - Manoj Kumar Kashyap
- Amity Medical School, Amity Stem Cell Institute, Amity University Haryana, Panchgaon, Haryana, India
- Clinical Biosamples & Research Services (CBRS), Noida, Uttar Pradesh, India
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Kerkutluoglu M, Gunes H, Iyigun U, Dagli M, Doganer A. Is the Effect of the COVID-19 Vaccine on Heart Rate Variability Permanent? MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050852. [PMID: 37241084 DOI: 10.3390/medicina59050852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/19/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023]
Abstract
Background and Objectives: The risk of autonomic dysfunction with COVID-19 vaccines used worldwide in the COVID-19 pandemic remains a topic of debate. Heart rate variability has a number of parameters that can be used to assess autonomic nervous system dynamics. The aim of this study was to investigate the effect of a COVID-19 vaccine (Pfizer-BioNTech) on heart rate variability and autonomic nervous system parameters, and the duration of the effect. Materials and Methods: A total of 75 healthy individuals who visited an outpatient clinic to receive the COVID-19 vaccination were included in this prospective observational study. Heart rate variability parameters were measured before vaccination and on days 2 and 10 after vaccination. SDNN, rMSSD and pNN50 values were evaluated for time series analyses, and LF, HF, and LF/HV values for frequency-dependent analyses. Results: The SDNN and rMSDD values declined significantly on day 2 after vaccination, while the pNN50 and LF/HF values increased significantly on day 10. The values at pre-vaccination and at day 10 were comparable. The pNN50 and LF/HF values declined significantly on day 2 and increased significantly on day 10. The values at pre-vaccination and at day 10 were comparable. Conclusions: This study showed that the decline in HRV observed with COVID-19 vaccination was temporary, and that the Pfizer-BioNTech COVID-19 vaccination did not cause permanent autonomic dysfunction.
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Affiliation(s)
- Murat Kerkutluoglu
- Department of Cardiology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras 46050, Turkey
| | - Hakan Gunes
- Department of Cardiology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras 46050, Turkey
| | - Ufuk Iyigun
- Department of Cardiology, Hatay Training and Research Hospital, Hatay 3100, Turkey
| | - Musa Dagli
- Department of Cardiology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras 46050, Turkey
| | - Adem Doganer
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras 46050, Turkey
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McLachlan CS, Truong H. A Narrative Review of Commercial Platforms Offering Tracking of Heart Rate Variability in Corporate Employees to Detect and Manage Stress. J Cardiovasc Dev Dis 2023; 10:jcdd10040141. [PMID: 37103020 PMCID: PMC10142541 DOI: 10.3390/jcdd10040141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/19/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
The COVID-19 pandemic has resulted in employees being at risk of significant stress. There is increased interest by employers to offer employees stress monitoring via third party commercial sensor-based devices. These devices assess physiological parameters such as heart rate variability and are marketed as an indirect measure of the cardiac autonomic nervous system. Stress is correlated with an increase in sympathetic nervous activity that may be associated with an acute or chronic stress response. Interestingly, recent studies have shown that individuals affected with COVID will have some residual autonomic dysfunction that will likely render it difficult to track both stress and stress reduction using heart rate variability. The aims of the present study are to explore web and blog information using five operational commercial technology solution platforms that offer heart rate variability for stress detection. Across five platforms we found a number that combined HRV with other biometrics to assess stress. The type of stress being measured was not defined. Importantly, no company considered cardiac autonomic dysfunction because of post-COVID infection and only one other company mentioned other factors affecting the cardiac autonomic nervous system and how this may impact HRV accuracy. All companies suggested they could only assess associations with stress and were careful not to claim HRV could diagnosis stress. We recommend that managers think carefully about whether HRV is accurate enough for their employees to manage their stress during COVID.
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Mavragani A, Suh YK. A Comprehensive Analysis of COVID-19 Vaccine Discourse by Vaccine Brand on Twitter in Korea: Topic and Sentiment Analysis. J Med Internet Res 2023; 25:e42623. [PMID: 36603153 PMCID: PMC9891356 DOI: 10.2196/42623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/28/2022] [Accepted: 01/05/2023] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The unprecedented speed of COVID-19 vaccine development and approval has raised public concern about its safety. However, studies on public discourses and opinions on social media focusing on adverse events (AEs) related to COVID-19 vaccine are rare. OBJECTIVE This study aimed to analyze Korean tweets about COVID-19 vaccines (Pfizer, Moderna, AstraZeneca, Janssen, and Novavax) after the vaccine rollout, explore the topics and sentiments of tweets regarding COVID-19 vaccines, and examine their changes over time. We also analyzed topics and sentiments focused on AEs related to vaccination using only tweets with terms about AEs. METHODS We devised a sophisticated methodology consisting of 5 steps: keyword search on Twitter, data collection, data preprocessing, data analysis, and result visualization. We used the Twitter Representational State Transfer application programming interface for data collection. A total of 1,659,158 tweets were collected from February 1, 2021, to March 31, 2022. Finally, 165,984 data points were analyzed after excluding retweets, news, official announcements, advertisements, duplicates, and tweets with <2 words. We applied a variety of preprocessing techniques that are suitable for the Korean language. We ran a suite of analyses using various Python packages, such as latent Dirichlet allocation, hierarchical latent Dirichlet allocation, and sentiment analysis. RESULTS The topics related to COVID-19 vaccines have a very large spectrum, including vaccine-related AEs, emotional reactions to vaccination, vaccine development and supply, and government vaccination policies. Among them, the top major topic was AEs related to COVID-19 vaccination. The AEs ranged from the adverse reactions listed in the safety profile (eg, myalgia, fever, fatigue, injection site pain, myocarditis or pericarditis, and thrombosis) to unlisted reactions (eg, irregular menstruation, changes in appetite and sleep, leukemia, and deaths). Our results showed a notable difference in the topics for each vaccine brand. The topics pertaining to the Pfizer vaccine mainly mentioned AEs. Negative public opinion has prevailed since the early stages of vaccination. In the sentiment analysis based on vaccine brand, the topics related to the Pfizer vaccine expressed the strongest negative sentiment. CONCLUSIONS Considering the discrepancy between academic evidence and public opinions related to COVID-19 vaccination, the government should provide accurate information and education. Furthermore, our study suggests the need for management to correct the misinformation related to vaccine-related AEs, especially those affecting negative sentiments. This study provides valuable insights into the public discourses and opinions regarding COVID-19 vaccination.
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Affiliation(s)
| | - Young-Kyoon Suh
- School of Computer Science and Engineering, Kyungpook National University, Daegu, Republic of Korea.,Department of Data Convergence Computing, Kyungpook National University, Daegu, Republic of Korea
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Pho GN, Thigpen N, Patel S, Tily H. Feasibility of Measuring Physiological Responses to Breakthrough Infections and COVID-19 Vaccine Using a Wearable Ring Sensor. Digit Biomark 2023; 7:1-6. [PMID: 37008738 PMCID: PMC10062187 DOI: 10.1159/000528874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/16/2022] [Indexed: 03/31/2023] Open
Abstract
Continuous monitoring using commercial-grade wearable technology was used to quantify the physiological response to reported COVID-19 infections and vaccinations in five biometric measurements. Larger responses were observed following confirmed COVID-19 infection reported by unvaccinated versus vaccinated individuals. Responses following reported vaccination were smaller in both magnitude and duration compared to infection and mediated by both dose number and age. Our results suggest commercial-grade wearable technology as a potential platform on which to build screening tools for early detection of illness, including COVID-19 breakthrough cases.
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Affiliation(s)
| | | | | | - Hal Tily
- Ōura Health Ltd, San Francisco, CA, USA
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10
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Kwon CY, Lee B. Impact of COVID-19 Vaccination on Heart Rate Variability: A Systematic Review. Vaccines (Basel) 2022; 10:vaccines10122095. [PMID: 36560505 PMCID: PMC9787739 DOI: 10.3390/vaccines10122095] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/04/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
Establishing and disseminating evidence-based safety information could potentially facilitate beneficial choices in coronavirus disease (COVID-19) vaccinations. This systematic review investigated the potential impact of COVID-19 vaccinations on human heart rate variability (HRV) parameters through comprehensive searches of four electronic medical databases. Five observational studies reporting HRV parameters of individuals vaccinated against COVID-19 and published up to 29 July 2022 were included in this review. Among them, four studies reported the square root of the mean squared differences of successive NN intervals (RMSSD) as their outcome, and the remaining study reported an HRV-based stress indicator. These studies reported short-term changes and rapid recovery in HRV parameters within up to 3 days after COVID-19 vaccination. Some studies showed that the impact of COVID-19 vaccinations on RMSSD was greater in women than men, and in the younger group than in the older group. The methodological quality of the included studies was not optimal; the review revealed short-term changes in HRV parameters, particularly RMSSD, following COVID-19 vaccination. However, as the included studies did not report important parameters besides RMSSD, the limitation exists that the postvaccination long-term HRV stability was not reported.
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Affiliation(s)
- Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-Eui University College of Korean Medicine, 52-57, Yangjeong-ro, Busanjin-gu, Busan 47227, Republic of Korea
| | - Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, 1672, Yuseong-daero, Yuseong-gu, Daejeon 34054, Republic of Korea
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11
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Mofaz M, Yechezkel M, Guan G, Brandeau ML, Patalon T, Gazit S, Yamin D, Shmueli E. Self-Reported and Physiologic Reactions to Third BNT162b2 mRNA COVID-19 (Booster) Vaccine Dose. Emerg Infect Dis 2022; 28:1375-1383. [PMID: 35654410 PMCID: PMC9239876 DOI: 10.3201/eid2807.212330] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Despite extensive technological advances in recent years, objective and continuous assessment of physiologic measures after vaccination is rarely performed. We conducted a prospective observational study to evaluate short-term self-reported and physiologic reactions to the booster BNT162b2 mRNA (Pfizer-BioNTech, https://www.pfizer.com) vaccine dose. A total of 1,609 participants were equipped with smartwatches and completed daily questionnaires through a dedicated mobile application. The extent of systemic reactions reported after the booster dose was similar to that of the second dose and considerably greater than that of the first dose. Analyses of objective heart rate and heart rate variability measures recorded by smartwatches further supported this finding. Subjective and objective reactions after the booster dose were more apparent in younger participants and in participants who did not have underlying medical conditions. Our findings further support the safety of the booster dose from subjective and objective perspectives and underscore the need for integrating wearables in clinical trials.
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12
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Li X, Gao L, Tong X, Chan VK, Chui CS, Lai FT, Wong CK, Wan EY, Chan EW, Lau KK, Lau CS, Wong IC. Autoimmune conditions following mRNA (BNT162b2) and inactivated (CoronaVac) COVID-19 vaccination: A descriptive cohort study among 1.1 million vaccinated people in Hong Kong. J Autoimmun 2022; 130:102830. [PMID: 35461018 PMCID: PMC9008125 DOI: 10.1016/j.jaut.2022.102830] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/31/2022] [Accepted: 03/31/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Concerns regarding the autoimmune safety of COVID-19 vaccines may negatively impact vaccine uptake. We aimed to describe the incidence of autoimmune conditions following BNT162b2 and CoronaVac vaccination and compare these with age-standardized incidence rates in non-vaccinated individuals. METHODS This is a descriptive cohort study conducted in public healthcare service settings. Territory-wide longitudinal electronic medical records of Hong Kong Hospital Authority users (≥16 years) were linked with COVID-19 vaccination records between February 23, 2021 and June 30, 2021. We classified participants into first/second dose BNT162b2 groups, first/second dose CoronaVac groups and non-vaccinated individuals for incidence comparison. The study outcomes include hospitalized autoimmune diseases (16 types of immune-mediated diseases across six body systems) within 28 days after first and second dose of vaccination. Age-standardized incidence rate ratios (IRRs) with exact 95% confidence intervals (CIs) were estimated using Poisson distribution. RESULTS This study included around 3.9 million Hong Kong residents, of which 1,122,793 received at least one dose of vaccine (BNT162b2: 579,998; CoronaVac: 542,795), and 721,588 completed two doses (BNT162b2: 388,881; CoronaVac: 332,707). Within 28 days following vaccination, cumulative incidences for all autoimmune conditions were below 9 per 100,000 persons, for both vaccines and both doses. None of the age-standardized incidence rates were significantly higher than the non-vaccinated individuals, except for an observed increased incidence of hypersomnia following the first dose of BNT162b2 (standardized IRR: 1.47; 95% CI: 1.10-1.94). CONCLUSIONS Autoimmune conditions requiring hospital care are rare following mRNA and inactivated COVID-19 vaccination with similar incidence to non-vaccinated individuals. The association between first dose BNT162b2 vaccination and immune-related sleeping disorders requires further research. Population-based robust safety surveillance is essential to detect rare and unexpected vaccine safety events.
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Affiliation(s)
- Xue Li
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China,Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China,Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Sha Tin, Hong Kong, China
| | - Le Gao
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Xinning Tong
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Vivien K.Y. Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Celine S.L. Chui
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Sha Tin, Hong Kong, China,School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China,School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Francisco T.T. Lai
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China,Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Sha Tin, Hong Kong, China
| | - Carlos K.H. Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China,Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Eric Y.F. Wan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China,Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Sha Tin, Hong Kong, China,Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Esther W.Y. Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China,Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Sha Tin, Hong Kong, China
| | - Kui Kai Lau
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
| | - Chak Sing Lau
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Ian C.K. Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China,Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Sha Tin, Hong Kong, China,Research Department of Practice and Policy, School of Pharmacy, University College London, United Kingdom,Expert Committee on Clinical Events Assessment Following COVID-19 Immunization, Department of Health, The Government of the Hong Kong Special Administrative Region, Hong Kong, China,Corresponding author. Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, L2-57, Laboratory Block, 21 Sassoon Road, Pokfulam, Hong Kong, China
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Gepner Y, Mofaz M, Oved S, Yechezkel M, Constantini K, Goldstein N, Eisenkraft A, Shmueli E, Yamin D. Utilizing wearable sensors for continuous and highly-sensitive monitoring of reactions to the BNT162b2 mRNA COVID-19 vaccine. COMMUNICATIONS MEDICINE 2022; 2:27. [PMID: 35603274 PMCID: PMC9053261 DOI: 10.1038/s43856-022-00090-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 02/15/2022] [Indexed: 12/23/2022] Open
Abstract
Background Clinical trial guidelines for assessing the safety of vaccines, are primarily based on self-reported questionnaires. Despite the tremendous technological advances in recent years, objective, continuous assessment of physiological measures post-vaccination is rarely performed. Methods We conducted a prospective observational study during the mass vaccination campaign in Israel. 160 participants >18 years who were not previously found to be COVID-19 positive and who received the BNT162b2 COVID-19 (Pfizer BioNTech) vaccine were equipped with an FDA-approved chest-patch sensor and a dedicated mobile application. The chest-patch sensor continuously monitored 13 different cardiovascular, and hemodynamic vitals: heart rate, blood oxygen saturation, respiratory rate, systolic and diastolic blood pressure, pulse pressure, mean arterial pressure, heart rate variability, stroke volume, cardiac output, cardiac index, systemic vascular resistance and skin temperature. The mobile application collected daily self-reported questionnaires on local and systemic reactions. Results We identify continuous and significant changes following vaccine administration in nearly all vitals. Markedly, these changes are observed even in presumably asymptomatic participants who did not report any local or systemic reaction. Changes in vitals are more apparent at night, in younger participants, and in participants following the second vaccine dose. Conclusion the considerably higher sensitivity of wearable sensors can revolutionize clinical trials by enabling earlier identification of abnormal reactions with fewer subjects. The safety of vaccines in clinical trials is primarily determined by participants completing self-reported questionnaires. We monitored various indicators of participant’s health using a chest-patch sensor in 160 participants before and after receiving the BNT162b2 COVID-19 (Pfizer BioNTech) vaccine. Participants were also asked to self-report their health via a mobile phone app. We observed significant changes in health indicators following vaccine administration. Changes were seen by chest patch sensor in both participants who did and did not report changes via the mobile phone app. Three days following vaccination, participant health indicators returned to the levels observed the day before vaccination in both groups. Using wearable sensors could potentially improve clinical trials by enabling earlier identification of abnormal reactions. Gepner et al. undertake a prospective observational study using a chest-patch sensor to monitor cardiovascular and hemodynamic vital signs following the BNT162b2 COVID-19 (Pfizer BioNTech) vaccine. Continuous and significant changes occurred in the vital signs, including in participants who did not report any reactions.
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Mason AE, Kasl P, Hartogensis W, Natale JL, Dilchert S, Dasgupta S, Purawat S, Chowdhary A, Anglo C, Veasna D, Pandya LS, Fox LM, Puldon KY, Prather JG, Gupta A, Altintas I, Smarr BL, Hecht FM. Metrics from Wearable Devices as Candidate Predictors of Antibody Response Following Vaccination against COVID-19: Data from the Second TemPredict Study. Vaccines (Basel) 2022; 10:264. [PMID: 35214723 PMCID: PMC8877860 DOI: 10.3390/vaccines10020264] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/27/2022] [Accepted: 02/03/2022] [Indexed: 01/27/2023] Open
Abstract
There is significant variability in neutralizing antibody responses (which correlate with immune protection) after COVID-19 vaccination, but only limited information is available about predictors of these responses. We investigated whether device-generated summaries of physiological metrics collected by a wearable device correlated with post-vaccination levels of antibodies to the SARS-CoV-2 receptor-binding domain (RBD), the target of neutralizing antibodies generated by existing COVID-19 vaccines. One thousand, one hundred and seventy-nine participants wore an off-the-shelf wearable device (Oura Ring), reported dates of COVID-19 vaccinations, and completed testing for antibodies to the SARS-CoV-2 RBD during the U.S. COVID-19 vaccination rollout. We found that on the night immediately following the second mRNA injection (Moderna-NIAID and Pfizer-BioNTech) increases in dermal temperature deviation and resting heart rate, and decreases in heart rate variability (a measure of sympathetic nervous system activation) and deep sleep were each statistically significantly correlated with greater RBD antibody responses. These associations were stronger in models using metrics adjusted for the pre-vaccination baseline period. Greater temperature deviation emerged as the strongest independent predictor of greater RBD antibody responses in multivariable models. In contrast to data on certain other vaccines, we did not find clear associations between increased sleep surrounding vaccination and antibody responses.
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Affiliation(s)
- Ashley E. Mason
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA 94115, USA; (W.H.); (A.C.); (C.A.); (D.V.); (L.S.P.); (L.M.F.); (K.Y.P.); (J.G.P.); (F.M.H.)
| | - Patrick Kasl
- Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA 92093, USA; (P.K.); (J.L.N.); (A.G.); (I.A.); (B.L.S.)
| | - Wendy Hartogensis
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA 94115, USA; (W.H.); (A.C.); (C.A.); (D.V.); (L.S.P.); (L.M.F.); (K.Y.P.); (J.G.P.); (F.M.H.)
| | - Joseph L. Natale
- Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA 92093, USA; (P.K.); (J.L.N.); (A.G.); (I.A.); (B.L.S.)
| | - Stephan Dilchert
- Department of Management, Zicklin School of Business, Baruch College, The City University of New York, New York, NY 10010, USA;
| | - Subhasis Dasgupta
- San Diego Supercomputer Center, University of California San Diego, San Diego, CA 92093, USA; (S.D.); (S.P.)
| | - Shweta Purawat
- San Diego Supercomputer Center, University of California San Diego, San Diego, CA 92093, USA; (S.D.); (S.P.)
| | - Anoushka Chowdhary
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA 94115, USA; (W.H.); (A.C.); (C.A.); (D.V.); (L.S.P.); (L.M.F.); (K.Y.P.); (J.G.P.); (F.M.H.)
| | - Claudine Anglo
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA 94115, USA; (W.H.); (A.C.); (C.A.); (D.V.); (L.S.P.); (L.M.F.); (K.Y.P.); (J.G.P.); (F.M.H.)
| | - Danou Veasna
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA 94115, USA; (W.H.); (A.C.); (C.A.); (D.V.); (L.S.P.); (L.M.F.); (K.Y.P.); (J.G.P.); (F.M.H.)
| | - Leena S. Pandya
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA 94115, USA; (W.H.); (A.C.); (C.A.); (D.V.); (L.S.P.); (L.M.F.); (K.Y.P.); (J.G.P.); (F.M.H.)
| | - Lindsey M. Fox
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA 94115, USA; (W.H.); (A.C.); (C.A.); (D.V.); (L.S.P.); (L.M.F.); (K.Y.P.); (J.G.P.); (F.M.H.)
| | - Karena Y. Puldon
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA 94115, USA; (W.H.); (A.C.); (C.A.); (D.V.); (L.S.P.); (L.M.F.); (K.Y.P.); (J.G.P.); (F.M.H.)
| | - Jenifer G. Prather
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA 94115, USA; (W.H.); (A.C.); (C.A.); (D.V.); (L.S.P.); (L.M.F.); (K.Y.P.); (J.G.P.); (F.M.H.)
| | - Amarnath Gupta
- Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA 92093, USA; (P.K.); (J.L.N.); (A.G.); (I.A.); (B.L.S.)
- San Diego Supercomputer Center, University of California San Diego, San Diego, CA 92093, USA; (S.D.); (S.P.)
| | - Ilkay Altintas
- Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA 92093, USA; (P.K.); (J.L.N.); (A.G.); (I.A.); (B.L.S.)
- San Diego Supercomputer Center, University of California San Diego, San Diego, CA 92093, USA; (S.D.); (S.P.)
| | - Benjamin L. Smarr
- Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA 92093, USA; (P.K.); (J.L.N.); (A.G.); (I.A.); (B.L.S.)
| | - Frederick M. Hecht
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA 94115, USA; (W.H.); (A.C.); (C.A.); (D.V.); (L.S.P.); (L.M.F.); (K.Y.P.); (J.G.P.); (F.M.H.)
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