Observational Digital Biomarker Discovery in Respiratory Virus Challenge Studies

Background:

Respiratory viruses circulate throughout the year and around the globe. Wearable and sensor devices, like smartwatches, may be able to help monitor infectious diseases. Researchers want to use them to learn how respiratory viruses affect people in different ways.

Objective:

To use digital devices to collect data from participants in challenge studies that could indicate subtle changes in health during an infection that might otherwise go unnoticed.

Eligibility:

Healthy adults who have enrolled, were recently enrolled, or are scheduled to enroll in a challenge study.

Design:

Participants will stay at NIH for the duration of the challenge study (at least 9 days) and then will have outpatient follow-up visits (2-4).

While at NIH, participants will wear a smartwatch at all times. It will record data like temperature, heart rate, breathing rate, and movements.

Participants will have a smartphone that records at all times to listen for coughing and changes in voice.

Participants will perform tasks every 4 hours during the daytime. They will record themselves coughing, breathing in deeply, and reading aloud. They will take videos of their face. They will play a game to test their reflexes and focus. They will measure their head temperature with their smartwatch.

For outpatient visits, participants will use one smartphone and the smartwatch to complete the above tasks.

Participants will be sent a smartwatch to wear at home at night to collect additional healthy data.

Participation will last the duration of each challenge study, and may range from 10 weeks to 2 years.

Study Overview

• Status: Recruiting
• Conditions: Influenza; Coronavirus; Respiratory Virus

Detailed Description

Study Description:

Wearable and sensor digital devices have the potential to be important tools in infectious diseases surveillance. In this study, digital devices will be used to evaluate responses before and after respiratory virus challenge on a separate NIH protocol. Participants recently enrolled, currently enrolled, or planned for enrollment in a challenge study are eligible. Devices will be worn and/or used during the inpatient hospitalization and at outpatient follow-up visits. Participants may be sent smartwatches at home to collect additional baseline or healthy data. Devices may collect data on coughing, speech, heart rate, heart rhythm, sweating, and temperature to identify digital biomarkers associated with respiratory virus infection. The correlation between digital device measurement data and clinical data, particularly on cough, will be determined. We hypothesize that sensor-collected data will correlate with symptom severity obtained by clinician assessment and participant report. We also hypothesize that digital biomarkers can predict influenza infection and can be used to develop a predictive model.

Objectives:

• Primary:

  1. To correlate continuous cough sensor data to cough severity after challenge.
  2. To develop a predictive model for mild-moderate influenza disease (MMID) and influenza infection using digital biomarkers
• Secondary: To correlate continuous and noncontinuous vital sign sensor data to routine vital signs obtained by clinical staff.

• Exploratory:

  1. To evaluate body sensor data after challenge.
  2. To correlate digital biomarker data to biological biomarker data.

Endpoints:

Primary:

1. Cough quantity:

   -Continuous cough measurements

2. Infection

   • Defined as:

     • MMID (positive PCR for influenza and >=1 symptoms)
     • Flu (positive PCR for influenza or convalescent four-fold increase in serum antibodies to the hemagglutinin (HA) or neuraminidase (NA) of the challenge virus and >=1 symptoms)
     • Influenza infection (positive PCR for influenza)

   • Using predictor variables such as:

     • Smartwatch photoplethysmography (PPG) determined heart rate
     • Smartwatch electrodermal activity (EDA) determined sweating
     • Smartwatch determined temperature
     • Smartwatch Electrocardiogram (ECG) monitoring
     • Audio voice recording

   Secondary: Vital signs:

3. Heart rate
4. Respiratory rate
5. Temperature

Exploratory:

Correlations between digital biomarker data and biological biomarker data (e.g. antibody titers)

• Study Type: Observational
• Enrollment (Estimated): 1000

Contacts and Locations

• Study Contact: Name: Luca T Giurgea, M.D.; Phone Number: (301) 538-5235; Email: luca.giurgea@nih.gov
• Study Contact Backup: Name: Rani S Athota, Ph.D.; Phone Number: (301) 594-0803; Email: rani.athota@nih.gov

Study Locations

• United States
  • Maryland
    • Bethesda, Maryland, United States, 20892
      • Recruiting
      • National Institutes of Health Clinical Center
      • Contact: For more information at the NIH Clinical Center contact Office of Patient Recruitment (OPR); Phone Number: TTY8664111010 800-411-1222; Email: prpl@cc.nih.gov

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Healthy volunteers currently enrolled in a respiratory virus challenge study

Description

• INCLUSION CRITERIA:

In order to be eligible to participate in this study, an individual must meet all of the following criteria:

1. Able to provide informed consent.
2. Current, recent, or planned enrollment in a respiratory virus challenge study at the NIH Clinical Center.
3. Willing to wear devices as instructed.
4. Willing to participate in monitoring activities as instructed.
5. Willing to have monitoring data stored.
6. Willing to have monitoring data shared with protocol investigators at NIH, University of Washington, and University of Toronto.
7. Willing to have select clinical data from the challenge study such as vital signs, viral shedding, pulmonary function test and/or spirometry results, and clinical symptoms data shared with investigators at University of Washington and University of Toronto.

EXCLUSION CRITERIA:

An individual who meets any of the following criteria will be excluded from participation in this study:

1. Any condition that, in the opinion of the investigator, contraindicates participation in this study.

Co-enrollment guidelines: Participants must be co-enrolled, planned for co-enrollment, or recently enrolled in a challenge study. Co-enrollment in other studies is restricted but may take place after study staff notification and only with approval of the principal investigator or designee.

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Current Challenge Study Participant; Current participation in a respiratory virus challenge study at the NIH CC

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To correlate continuous cough sensor data to cough severity after challenge.To develop a predictive model for MMID and asymptomatic influenza infection using digital biomarkers.	Cough is a known symptom of respiratory virus infections and can be quantified by objective measurements.Data from smart devices may be able to discern who gets sick with a respiratory virus and could be utilized as a diagnostic tool.	minimum of 9 days inpatient

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To correlate continuous and noncontinuous vital signs sensor data to routine vital signs obtained by clinical staff.	Vital signs are routinely measured in challenge studies and are also routinely collected from digital devices. Vital sign changes can be associated with respiratory virus infections.	minimum of 9 days inpatient

Collaborators and Investigators

• Sponsor: National Institute of Allergy and Infectious Diseases (NIAID)
• Investigators: Principal Investigator: Luca T Giurgea, M.D., National Institute of Allergy and Infectious Diseases (NIAID)

Publications and helpful links

Helpful Links

• NIH Clinical Center Detailed Web Page

Study record dates

Study Major Dates

• Study Start (Actual): October 23, 2023
• Primary Completion (Estimated): June 2, 2026
• Study Completion (Estimated): June 2, 2026

Study Registration Dates

• First Submitted: February 25, 2021
• First Submitted That Met QC Criteria: February 25, 2021
• First Posted (Actual): February 26, 2021

Study Record Updates

• Last Update Posted (Actual): June 2, 2026
• Last Update Submitted That Met QC Criteria: May 30, 2026
• Last Verified: May 27, 2026

More Information

Terms related to this study

• Keywords: Natural History; Smartphone; Wearable Digital Device; Bed Sensor; Cough Count; Smartwatch
• Additional Relevant MeSH Terms: Respiratory Tract Infections; Infections; Orthomyxoviridae Infections; RNA Virus Infections; Virus Diseases; Respiratory Tract Diseases; Coronaviridae Infections; Nidovirales Infections; Influenza, Human; Coronavirus Infections
• Other Study ID Numbers: 10000291; 000291-I

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No