Postdischarge recovery after acute pediatric lung disease can be quantified with digital biomarkers

Kruizinga, M.D.; Moll, A.; ZhuParris, A.; Ziagkos, D.; Stuurman, F.E.; Nuijsink, M.; ... ; Driessen, G.J.A. (2021)

Article / Letter to editor

Background: Pediatric patients admitted for acute lung disease are treated and monitored in the hospital, after which full recovery is achieved at home. Many studies report in-hospital recovery, but little is known regarding the time to full recovery after hospital discharge. Technological innovations have led to increased interest in home-monitoring and digital biomarkers. The aim of this study was to describe at-home recovery of 3 common pediatric respiratory diseases using a questionnaire and wearable device. Methods: In this study, patients admitted due to pneumonia (n = 30), preschool wheezing (n = 30), and asthma exacerbation (AE; n = 11) were included. Patients were monitored with a smartwatch and a questionnaire during admission, with a 14-day recovery period and a 10-day "healthy" period. Median compliance was calculated, and a mixed-effects model was fitted for physical activity and heart rate (HR) to describe the recovery period, and the physical activity recovery trajectory was correlated to respiratory symptom scores. Results: Median compliance was 47% (interquartile range [IQR] 33-81%) during the entire study period, 68% (IQR 54-91%) during the recovery period, and 28% (IQR 0-74%) during the healthy period. Patients with pneumonia reached normal physical activity 12 days postdischarge, while subjects with wheezing and AE reached this level after 5 and 6 days, respectively. Estimated mean physical activity was closely correlated with the estimated mean symptom score. HR measured by the smartwatch showed a similar recovery trajectory for subjects with wheezing and asthma, but not for subjects with pneumonia. Conclusions: The digital biomarkers, physical activity, and HR obtained via smartwatch show promise for quantifying postdischarge recovery in a noninvasive manner, which can be useful in pediatric clinical trials and clinical care.

• Pediatrics
• Wearable
• Acute lung disease
• At-home recovery
• Linear mixed model
• Pneumonia
• Wheezing
• Asthma

• All authors: Kruizinga, M.D.; Moll, A.; ZhuParris, A.; Ziagkos, D.; Stuurman, F.E.; Nuijsink, M.; Cohen, A.F.; Driessen, G.J.A.
• Date: 2021-05-18
• Journal: Respiration
• Volume: 100
• Issue: 10
• Pages: 979 - 988
• DOI: doi:10.1159/000516328