Mount Sinai researchers using Apple Watch to study COVID-19 stress


Researchers at Mount Sinai are the latest to leverage wearables to study the COVID-19 crisis. By using the Apple Watch in combination with a unique phone app and simple survey questions, they hope to study the psychological impact of COVID-19 and potentially flag early signs of the disease.

Other researchers have used surveys or medical devices to try and track the spread of the novel coronavirus. What sets their study apart, say Dr. Robert Hirten and Zahi Fayad of the Mount Sinai COVID Informatics Center, is its specific focus on healthcare workers across a variety of occupations.

“We didn’t want to focus on a specific group of healthcare workers,” said Hirten in an interview with Healthcare IT News. “We wanted to assess the psychological stress across the spectrum so we can really see who the groups of people are who might be most in need of help.”

As Hirten pointed out, it’s not just frontline workers who are at risk of the psychological and physical impacts of COVID-19. “A person coming in after a [COVID-19] patient is in the room – there’s a lot of risk for the person cleaning the room,” he said.

Earlier this month, Apple CEO Tim Cook called specific attention to the study as an opportunity to improve healthcare using the Watch.

“Healthcare providers, insurance companies and businesses are also seeing the benefits of offering Apple Watch. They know it can make a big difference in the lives of their patients, customers and employees,” said Cook at the Apple Event in September.

“Recently, the Mount Sinai Health System in New York launched the new Warrior Watch study. Using data from Apple Watch, researchers are studying the impact of COVID on the psychological wellbeing of frontline health care workers by identifying early signs of stress while also looking to predict infection before symptoms appear,” Cook said.

Hirten and Fayad said they’d had previous experience with the Apple health kit and had expert engineers on the team who had done work in the past to customize apps and extract specific physiological measures from the Watch.

For this study, they said, the key measure is heart rate variability, which can shed light on the nervous system.

Perhaps counterintuitively, a lower variability in heart rate is associated with the risk of disease. It means your system is stressed.

“One of the limitations in the literature is they’ve really relied on a single mode of data,” said Hirten. “It’s usually asking people questions: ‘How are your stress perceptions? What is worrying you?'”

This study, he said, will combine “subjective measures” – in other words, answering those kinds of questions – “with physical metrics of what’s going on in bodies.”

Another advantage of using Mount Sinai employees, they said, is that they also have access to their medical records, which allows them to get a more complete picture of individuals.

Recruitment is still ongoing, said the researchers. Although interest has been high, they’ve faced hurdles in actually getting Apple Watches into the hands of the people who want to participate.

“We’ve had team members ride around on a bicycle around Manhattan to Apple stores trying to get the watches,” laughed Fayad.

Eventually, they hope to have about 1,000 people enrolled.

The researchers said that following Cook’s shout-out they plan to meet with Apple higher-ups in the next few weeks to have a deeper discussion about the study.

“The hope is that we’re able to identify people who aren’t doing well psychologically … and identify people who are infected with [COVID-19] very early on in the infection or … are asymptomatic carriers,” said Hirten.