COVID-19 affects men and women differently, with men having greater increases in skin temperature, breathing rate, and heart rate, concludes a study published yesterday in PLOS One.
Researchers in Liechtenstein led the analysis of breathing rate, heart rate, heart rate variability, and wrist skin temperature in 1,163 men and women who wore the Ava medical tracking bracelet while sleeping from April 2020 to January 2022.
Measurements every 10 seconds during sleep
The average patient age was 44.1 years, and 57% were women. Participants were a subset of those enrolled in the Genetic and Phenotypic Determinants of Blood Pressure and Other Cardiovascular Risk Factors study.
The bracelet collected more than 1.5 million hours of daily biophysical data to detect COVID-19 infections and responses. Every 10 seconds, the device measured breathing rate, heart rate, heart rate variability, and wrist skin temperature.
Patients supplied COVID-19 serologic samples at baseline and follow-up and reported daily symptoms and potential confounding factors (alcohol, medication, and drug intake) via a complementary smartphone app. They also completed questionnaires every 6 months on personal information, smoking status, and any COVID-19 symptoms and hospitalizations.
The investigators using multilevel modeling and T-tests to detect potential sex-specific differences in physiologic responses and antibody levels.
Partial explanation for men's vulnerability to COVID
A total of 127 participants (10.9%) tested positive for COVID-19, of whom 82 had enough quality data from the app to include in the analysis. During the symptomatic phase of infection, relative to women, men exhibited greater increases in skin temperature, breathing rate, and heart rate, as well as larger declines in heart rate variability.
Also, men's breathing and heart rates stayed significantly higher than women's during recovery. The researchers found that potential confounding factors such as body mass index, age, high blood pressure, and drug and alcohol use didn't affect the associations between sex and physiology during illness, but the study couldn't account for menstruation-related hormonal changes in women.
Wearable technology, capable of providing a reliable history of measurements, can empower clinicians with invaluable insights into individual patient health.
Antibody concentrations didn't differ significantly by sex, and the device's algorithm was equally precise in both groups.
The authors said that sex-specific biologic responses to COVID-19 infection might at least partially account for men's higher hospitalization and death rates. "As the autonomic nervous system is known to modulate inflammation and the examined physiological signals reflect the function of the autonomic nervous system, our findings suggest support for differential immunological responses to COVID-19 between the sexes," they wrote.
The results highlight the importance of considering sex in the treatment of COVID-19 and when validating infection-detection algorithms in digital health, the researchers said. "Wearable technology, capable of providing a reliable history of measurements, can empower clinicians with invaluable insights into individual patient health, enabling more personalized and timely interventions that hold promise for improved patient outcomes in the fight against COVID-19 and beyond," they wrote.
