Using smartwatches to observe changes in activity during recovery from critical illness following COVID-19: a 1 year multi-centre observational study

Alex Hunter, Todd Leckie, Oliver Coe, Benjamin Hardy, Daniel Fitzpatrick, Ana-Carolina Gonçalves, Mary Kate Standing, Christina Koulouglioti, Alan Richardson, Luke Hodgson

Research output: Contribution to journalArticlepeer-review


Background: As a sequelae of the COVID-19 pandemic, a large cohort of critical illness survivors have had to recover in the context of ongoing societal restrictions.

Objective:To observe the recovery of survivors of critical care admission with COVID-19 using smartwatches, evaluate how these devices enabled a remote multidisciplinary team (MDT) to support patient recovery, and assess the usability of these devices.
Methods: A prospective multi-centre observational trial in eight UK critical care units. 50 participants with moderate or severe lung injury as a result of confirmed COVID-19 disease were recruited at discharge from critical care and given a smartwatch (Fitbit Charge 3). Data collected included step count and daily resting heart rate (HR). A subgroup, the ‘MDT site’ (n=19), had their smartwatch data used to inform a regular MDT meeting. Devices were evaluated by use of a patient feedback questionnaire and direct feedback from the MDT. Participants that did not upload smartwatch data were excluded from analysis.

Results: From the overall cohort, 35 (70%) participants used and uploaded data from their smartwatch during the 1 year period. 14 users uploaded data from the MDT site. The overall cohort recorded a mean increase of 4359 (±3488) steps per day in the first month following discharge, to 7914(±4146) steps at 1 year (p<0.01). HR reduced from a mean of 79 (7) beats per minute in the first month to 69 (4) at one year following discharge (p<0.01)). The MDT subgroup increased mean step count by more than the control group (176 vs 42%, p=0.04) over the 1 year. 94% of fitbit users found their smartwatch easy to use and 80% felt that the technology helped and motivated them to recover.

Conclusions:This is the first study to report 1-year recovery of patients who survived COVID-19 critical illness using smartwatch technology. Future work could explore the role of smartwatches as part of a randomised controlled trial to assess clinical and economic effectiveness.
Original languageEnglish
Article numbere25494
Pages (from-to)e25494
Number of pages11
JournalJMIR Rehabilitation and Assistive Technologies
Issue number2
Publication statusPublished - 2 May 2022


  • COVID-19
  • telemedicine
  • rehabilitation
  • critical illness
  • smartphone
  • digital health
  • mobile health
  • remote therapy
  • device usability


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