By Allison Proffitt
April 2, 2020 | Last week, several groups released COVID-19 screening tools or symptom checkers to help track the spread of the virus, help people make decisions about when to receive care, and track trends. Apple and Seqster both launched symptom trackers in the United States. Covidaware.me launched internationally to track symptoms and share data, and the TwinsUK study launched a COVID-19 symptom tracker and research study using a cohort of twins.
Seqster launched its COVID-19 Compass module last Thursday. The Seqster interoperability platform is a SaaS healthcare platform that enables organizations to drive efficient healthcare via comprehensive medical records, individual genomic profiles, and personal health device data.
Through the COVID-19 Compass module, patients on the Seqster platform can share key health metrics related to COVID-19, such as body temperature, heart rate and pulse oximetry, already synced with devices connected to their Seqster profile, and can self-report on symptoms of COVID-19 like shortness of breath, fatigue, and coughing.
Interoperability has always been a core value of Seqster, Ardy Arianpour, CEO and co-founder told Diagnostics World News. And he believes the big picture, longitudinal view will be essential to advancing research for COVID-19.
A symptom checker is not enough, he says. “A symptom checker doesn’t do anything for you. But when you use a symptom checker and you’re able to collect all of your health data in one place… and then share that data with a provider, with a researcher, with a family member, that’s when you make change happen. For all of us.”
The module is now the first thing that pops up when anyone uses the Seqster platform, Arianpour says. Through a series of questions based on CDC’s guidelines, COVID-19 Compass assesses responses against four levels of illness severity: life threatening, severe, non-life threatening, minor symptoms typically correlated with COVID-19 and symptoms occasionally associated with COVID-19, he explains. Because the COVID-19 Compass exists within the Seqster system, it also factors in age, gender, location and potential exposures, and pre-existing health conditions.
Necessary actions are delivered directly to the user, and aggregate data are collected as well. “Seqster logs the answer to every question on each run of COVID-19 Compass and uses the answers to generate statistical tables and graphs to help patients, members, and the research community better understand the trends nationally and within their geographic region,” Arianpour says.
“You have to be able to not only geolocate the people that are having these symptoms or are testing positive, but with the Seqster interoperability technology, people can collect their electronic health record data and combine it with the COVID-19 Compass symptom checker and that’s where it’s really powerful for researchers or any providers that are looking to see what correlation in data look like,” Arianpour explains.
The module is now a part of all Seqster deployments, and Arianpour says the company has fielded requests from academic centers, pharmaceutical companies conducting clinical trials, researchers, private employers, and even the CDC since last week’s launch. The Seqster platform is not available directly to consumers.
Apple’s COVID-19 App
Widely available, but without medical records, is Apple’s new COVID-19 website and app created in partnership with the CDC, the White House Coronavirus Task Force, and FEMA and announced last Friday.
Both the Apple COVID-19 app and website allow users to answer a series of questions around risk factors, recent exposure, and symptoms for themselves or a loved one. They receive CDC recommendations on next steps, including guidance on social distancing and self-isolating, how to closely monitor symptoms, whether or not a test is recommended at this time, and when to contact a medical provider.
Users will receive answers to frequently asked questions about COVID-19, including who is most at risk and how to recognize symptoms. In addition, they will learn the most up-to-date information from the CDC like best practices for washing hands, disinfecting surfaces and monitoring symptoms.
Along with the new COVID-19 app and website, customers across the US may also ask Siri, “How do I know if I have coronavirus?” to access guidance and resources from the CDC and a curated collection of telehealth apps available on the App Store. This week, travelers landing at select international airports throughout the US started receiving notifications on their iPhone to remind them of current CDC guidance to stay home and monitor their health.
Global Pandemic, Global Effort
International groups have also launched trackers and studies. A precision medicine team out of Sydney, Australia, has launched Covidaware.me, an anonymous symptom tracker that helps patients distinguish between COVID-19, the flu, and a cold, compare their symptoms to others and to guidance issued by the World Health Organization and CDC, and share their data for research.
The site was developed by Pryzm Health in conjunction with the Monarch Institute, developer of the Human Phenotype Ontology. “We could see a really big gap in the marketplace and what people have been given as far as the overall pandemic control,” Robert Love, Pryzm’s CEO, told Diagnostics World News. “We could see that there was a real need to give people something they could engage with and do themselves, something that empowered them with information and then enable them to make some informed decisions.”
Covidaware.me was built on the back of the Pryzm Health electronic patient data capture platform, TackHeath, a HIPPA-complaint, trials-grade solution to support patient self-generated data for research and clinical management.
Globally, individuals can sign up for covidaware.me as anonymously as they’d like—“Any kind of crazy email is fine!” Love says. The consent process offers three options: participants can choose to, “help protect everyone by publicly sharing your data anonymously, help other users see trends by sharing your data anonymously with other covidaware.me users, or keep your data private.”
Participants can download their data as a Phenopacket, a Global Alliance for Genomics & Health approved standard, or delete their data at anytime.
To start a seven-day observation period, users enter relevant health history, and the system delivers an encrypted link to their mobile phone each day via SMS. Links take users to a daily questionnaire specific to COVID-19 symptoms.
Each enrollment period lasts seven days, and you can enlist again for additional seven-day periods. “Our initial intent was to pick up on the people who are self-isolating because they think they may have had a history of exposure, they’re compromised or have chronic diseases, or people who are immunocompromised,” Love says.
Love says more than 12,000 users began participating in the first few days: 60% were in the UK, about 30% from the US, and the remainder from the rest of the world.
Pryzm Health is an AI company that spun out of the Garvan Institute of Medical Research in Sydney about a year ago, Love explains. The company’s “primary mission is to combine our expertise and use the power of AI, big health data, and genomics through our partner BGI to really solve the diagnosis issues facing rare disease patients worldwide.”
The company uses its natural language processing prowess to do what Love calls, “patient self-phenotyping” for rare disease patients, and is in the final stages of a real world proof-of-concept integrating its AI engine into a leading primary care EMR to enable population-level screening and analytics for rare disease delivered straight into the point of care.
Since the pandemic, the company has turned its tools to the literature published on the novel coronavirus and COVID-19 from PubMed since October and is publishing annotation updates to GitHub.
“It’s almost a live dataset,” Love says. “There have been 17,000 abstracts put up on PubMed since March 17. This is really live, really fresh, and evolving. We’ve been using our NLP engine and we’ve characterized a set of symptoms. There’s about 2,200 terms that are popping up COVID when you look at what’s being reported by physicians in the case notes and the abstracts… It’s a very diverse set of symptoms when you look at the tails of what people are experiencing.”
Twin Impacts
Finally, in the United Kingdom, a COVID-19 symptom tracker has been launched by doctors and scientists at King's College London, Guys and St Thomas’ Hospitals working in partnership with ZOE Global. The tracker is available to anyone but will also be used in a special COVID-19 research study held in conjunction with the TwinsUK project.
Tim Spector, professor of genetic epidemiology at King’s College London and director of TwinsUK, is leading the effort. The TwinsUK project has been studying 15,000 identical and non-identical twins for nearly three decades. Most already have taken part in comprehensive genetic analysis and immune profiling, as well as detailed gut microbiome profiling.
Around 5,000 twins and their families across the UK have been recruited from the TwinsUK cohort study to trial the app, which tracks in real-time how the disease progresses. The participating twins can use the COVID-19 app to record information about their health on a daily basis, including temperature, tiredness and symptoms such as coughing, breathing problems or headaches. Any participants showing signs of COVID-19 will be sent a home testing kit to better understand what symptoms truly correspond to the coronavirus infection.
The general public will also have access to the study app, but they will not have access to the home testing kits.
As many companies seek ways to be involved in solutions for our current situation, more innovative efforts like these will arise.
“The more people that can work on COVID-19, the better for all of us,” points out Seqster’s Arianpour. “But more importantly, I think the rapid collection of data and sharing is what needs to happen at scale for us to fight this disease. The longer it takes to collect data, the longer it takes to do as much testing as possible, the longer it takes to identify the positives and the negatives and where they really are with the real numbers, that’s going to be detrimental to our timelines to putting this disease past us.”