A Micro-Level Analysis of Physiological Responses to COVID-19: Continuous Monitoring of Pregnant Women in California

Abstract

Continuous monitoring of perinatal women in a descriptive case study allowed us the opportunity to examine the time during which the COVID-19 infection led to physiological changes in two low-income pregnant women. An important component of this study was the use of a wearable sensor device, the Oura ring, to monitor and record vital physiological parameters during sleep. Two women in their second and third trimesters, respectively, were selected based on a positive COVID-19 diagnosis. Both women were tested using the polymerase chain reaction method to confirm the presence of the virus during which time we were able to collect these physiological data. In both cases, we observed 3–6 days of peak physiological changes in resting heart rate (HR), heart rate variability (HRV), and respiratory rate (RR), as well as sleep surrounding the onset of COVID-19 symptoms. The pregnant woman in her third trimester showed a significant increase in resting HR (p = 0.006) and RR (p = 0.048), and a significant decrease in HRV (p = 0.027) and deep sleep duration (p = 0.029). She reported experiencing moderate COVID-19 symptoms and did not require hospitalization. At 38 weeks of gestation, she had a normal delivery and gave birth to a healthy infant. The participant in her second trimester showed similar physiological changes during the 3-day peak period. Importantly, these changes appeared to return to the pre-peak levels. Common symptoms reported by both cases included loss of smell and nasal congestion, with one losing her sense of taste. Results suggest the potential to use the changes in cardiorespiratory responses and sleep for real-time monitoring of health and well-being during pregnancy.

How Wearable Sensors Can Support the Research on Foetal and Pregnancy Outcomes: A Scoping Review

“…Twenty-one studies described the application of wearable sensors to collect information about maternal parameters and activities during pregnancy [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. These studies are described in Table 2 , together with a summary of the design and population, wearable device used, and main findings.…”

“…In their first study, Jimah and colleagues reported significant correlations between objective and self-reported measures by analysing a pregnant woman at 33 weeks of gestation [ 31 ]. In a later study, these authors also reported physiological changes in resting heart rate and variability, respiratory, and sleep in two pregnant women after the onset of COVID-19 symptoms [ 32 ].…”

“…For the second domain of application, selected studies reported on wearable devices used to collect maternal parameters and activities during pregnancy, and to investigate their association with maternal and neonatal health [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. Devices used were varied, including wristband and finger-based trackers, body-conforming flexible sensors, and more complex systems made of different sensors.…”

“…This was important, for example, to monitor changes in physical activity levels and sleep patterns across trimesters of pregnancy [ 24 , 28 , 37 ], and to investigate possible associations with pregnancy outcomes (e.g., GDM, stress, depression, etc.) [ 23 , 24 , 27 , 31 , 32 ]. In addition, it has been demonstrated how some interventions based on wearable devices and other innovative technologies may support healthy behaviours and adequate weight gain during pregnancy [ 23 , 25 ].…”

The Impact of SARS-CoV-2 Infection on Heart Rate Variability: A Systematic Review of Observational Studies with Control Groups

“…After the initial screening, the full texts of the remaining 43 documents were reviewed. Three opinion articles [23][24][25], four review articles [6,[26][27][28], two case reports or case series [29,30], one long COVID study [31], five studies that did not report HRV [32][33][34][35][36], eleven studies without a control group [37][38][39][40][41][42][43][44][45][46][47], and one study that used data from the journal article which was the same as the data presented in the conference abstract [48] were excluded. The inter-rater agreement rate among the researchers in the full texts review was 97.67% (42/43).…”