The Evolving Symptoms and Variants

Since the first reported cases in December 2019, SARS-CoV-2 has infected millions of people worldwide, causing varying symptoms and outcomes. The symptoms of COVID-19 have evolved as new viral variants emerged, leading to changes in the clinical presentation and severity. Survivors of COVID-19 often report persistent symptoms that continue to affect their quality of life even after the acute illness phase. Notably, the prevalence and nature of these long-term symptoms have been found to differ across SARS-CoV-2 variants.

Study Design and Methodology

The prospective longitudinal cohort study analyzed data from UK-based adults, aged 18-100 years, who regularly reported their health status through the Covid Symptom Study smartphone app. The study included participants who tested positive for SARS-CoV-2 after being physically normal for at least 30 days. The researchers focused on individuals who developed symptoms lasting longer than 28 days from the initial positive test, defining this as long COVID. Additionally, they examined post-COVID-19 condition, which involved symptoms persisting for at least 84 days after the initial positive test. By employing unsupervised clustering analysis of time-series data, the researchers aimed to identify distinct symptom profiles for vaccinated and unvaccinated individuals across various SARS-CoV-2 variants.

Findings and Implications

The study included a total of 9,804 individuals with long COVID, of whom 15% developed a post-COVID-19 condition. The researchers identified different symptom profiles within and across variants. The wild-type variant (in unvaccinated people) showed four distinct endotypes. Alpha variant (in unvaccinated people) showed seven endotypes, while the vaccinated delta variant group exhibited five endotypes. Across all variants, researchers identified three main clusters of symptoms: cardiorespiratory, central neurological, and multi-organ systemic inflammatory. Gastrointestinal symptoms showed a less diverse clustering pattern across viral variants.

The findings shed light on the heterogeneous nature of post-COVID-19 condition, characterized by varying combinations of symptoms, durations, and functional outcomes.

This classification holds immense potential in enhancing our understanding of the different mechanisms underlying post-COVID-19 conditions, as well as identifying subgroups of individuals at risk of prolonged debilitation. Such insights are invaluable for tailoring personalized care and developing targeted interventions for affected individuals.

Conclusion

The rapid evolution and spread of SARS-CoV-2 have necessitated extensive research to comprehend its impact on human health. This study’s innovative approach, analyzing self-reported symptoms and leveraging clustering analysis, has contributed significantly to unraveling the diverse profiles of post-COVID-19 condition based on viral variants and vaccination status. By understanding the distinct characteristics of this condition, healthcare professionals can provide tailored care to individuals experiencing prolonged symptoms, thereby enhancing their well-being and recovery.

Funding for this study was provided by various organizations, including the UK Government Department of Health and Social Care, Wellcome Trust, and National Institute for Health Research, among others.

SEATTLE–(BUSINESS WIRE)–#globalhealth—Audere, a digital health nonprofit developing solutions to advance health equity, today announced HealthPulse TestNow, the first COVID-19 app deployed in South Africa that supports self-testers with the administration and interpretation of rapid diagnostic tests (RDT). HealthPulse TestNow helps ensure the accurate use of RDTs through easy-to-follow instructions, process control timers, and guided result interpretation. The solution seamlessly integrates with public health reporting systems and ensures that self-testing data is reported, providing a more comprehensive understanding of disease prevalence.

Self-testing is an important component of public health strategies worldwide, however, challenges exist with accurate and reliable test administration, interpretation, and collection of data that can compromise the benefits of these efforts. HealthPulse TestNow is designed to improve an individual’s self-testing aptitude while seamlessly connecting ministries of health with test data in an effort to maximize the end-to-end impact of public health programs.

“We are proud to announce the first deployment of HealthPulse TestNow in South Africa. While the current state of COVID-19 testing varies across communities, this AI-powered digital solution lays the foundation for a much needed self-testing tool that facilitates improved self-diagnosis and early access to care not just for COVID-19 but for a range of medical conditions. We are actively expanding the solution’s coverage to include new conditions across a broader set of geographies in Africa. Our mission is to empower early diagnosis and expedite access to care.”

– Dr. Dino Rech, CEO, Audere

The solution is initially available in South Africa for COVID-19 self-testing with Medical Diagnostech, a developer and manufacturer of lateral flow rapid diagnostic test kits, whose partnership with Audere was announced last year. Medical Diagnostech’s COVID-19 Antigen Self Test¹, the first COVID-19 self-test manufactured in Africa to receive South African Health Products Regulatory Authority (SAHPRA) approval in 2023, will be the first test covered by Audere’s HealthPulse TestNow digital companion app.

Learn more about Audere’s HealthPulse solutions by visiting https://healthpulsenow.org/.

About Audere

Audere is a global digital health nonprofit developing HealthPulse solutions to advance health equity in underserved communities worldwide. We operate at the unique intersection of global health and high tech, creating advanced, accessible software that revolutionizes the detection and treatment of diseases — such as malaria, COVID-19, and HIV. Our diverse team of passionate, innovative minds combines smartphone technology, artificial intelligence, and the best of cloud-based services to deliver HealthPulse solutions worldwide. Development of our projects is funded by grants and support from the Bill & Melinda Gates Foundation, FIND, and other global health partners. Learn more at auderenow.org.

About Medical Diagnostech

Medical Diagnostech was established in 2010 as a developer and manufacturer of lateral flow rapid diagnostic test kits. The Cape Town-based company manufactures high quality rapid diagnostic test kits using its secret methodology for increased sensitivity and early detection. Medical Diagnostech’s products are robust and are optimized to withstand extreme storage conditions for up to 24 months. Lateral flow tests are manufactured under ISO 13485 accreditation and include tests for alcohol consumption, drugs of abuse, HIV, malaria, pregnancy, fertility/ovulation and Covid-19.

_____________________________

¹The MD SARS-nCoV-2 Antigen Device is a rapid visual immunoassay for the qualitative detection of the COVID-19 Nucleocapsid protein (N-protein) antigen from lower nasal swabs. It is intended to accurately diagnose acute infection and informs on whether the patient is currently infected. NOTE: This is different to antibody tests which informs on whether the patient has built up immunity against the virus. Using N-protein technology for the detection of viral proteins, the MD SARS-CoV-2 Antigen device is highly sensitive and can detect viral antigens down to a concentration of ~ 1 ng/ml.

Contacts

Audere
Jennifer Thorson
Marketing
(425) 835-3801
info@healthpulsenow.org

Medical Diagnostech
Johan Maree
+27 21 982 0673
info@medi-tech.co.za

The updated report includes a total of 24 companies from the Nordic countries showcasing their solutions and ambitions, especially chosen for their relevance to the japanese market.

The Nordics and Japan have much in common, and face many of the same challenges. Both regions are relatively affluent, and technologically advanced. Both face an aging population and dwindling workforce, necessitating innovative solutions in healthcare technologies. The Nordic healthcare ecosystems are globally renowned for providing efficient, high-quality, population-wide health-care systems.

Nordic Healthtech has never been more relevant, especially in the wake of the COVID-19 pandemic. There is an urgent need for introducing solutions that enable remote monitoring and treatment of patients, and provide tools for prevention, earlier diagnosis, and self-help.

Download the full report

The World Health Organization (WHO) and the Federal Republic of Germany will establish a new global hub for pandemic and epidemic intelligence, data, surveillance and analytics innovation. The Hub, based in Berlin and working with partners around the world, will lead innovations in data analytics across the largest network of global data to predict, prevent, detect prepare for and respond to pandemic and epidemic risks worldwide.

H.E. German Federal Chancellor Dr Angela Merkel said:

The current Covid-19 pandemic has taught us that we can only fight pandemics and epidemics together. The new WHO Hub will be a global platform for pandemic prevention, bringing together various governmental, academic and private sector institutions. I am delighted that WHO chose Berlin as its location and invite partners from all around the world to contribute to the WHO hub.

The WHO Hub for Pandemic and Epidemic Intelligence is part of WHO’s Health Emergencies Programme and will be a new collaboration of countries and partners worldwide, driving innovations to increase availability and linkage of diverse data; develop tools and predictive models for risk analysis; and to monitor disease control measures, community acceptance and infodemics. Critically, the WHO Hub will support the work of public health experts and policy-makers in all countries with insights so they can take rapid decisions to prevent and respond to future public health emergencies.

We need to identify pandemic and epidemic risks as quickly as possible, wherever they occur in the world. For that aim, we need to strengthen the global early warning surveillance system with improved collection of health-related data and inter-disciplinary risk analysis, said Jens Spahn, German Minister of Health. “Germany has consistently been committed to support WHO’s work in preparing for and responding to health emergencies, and the WHO Hub is a concrete initiative that will make the world safer.

Working with partners globally, the WHO Hub will drive a scale-up in innovation for existing forecasting and early warning capacities in WHO and Member States. At the same time, the WHO Hub will accelerate global collaborations across public and private sector organizations, academia, and international partner networks. It will help them to collaborate and co-create the necessary tools for managing and analyzing data for early warning surveillance. It will also promote greater access to data and information.

One of the lessons of COVID-19 is that world needs a significant leap forward in data analysis to help leaders make informed public health decisions, said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. This requires harnessing the potential of advanced technologies such as artificial intelligence, combining diverse data sources, and collaborating across multiple disciplines. Better data and better analytics will lead to better decisions.

The Series D funding round was led by CPP Investments (CPPIB) and Fidelity Management & Research LLC with participation from existing investors, including the Ontario Teachers’ Pension Plan (Ontario Teachers’), Index Ventures, Accel, Creandum and Project A.

Kry will use the investment to scale its platform, building on both its operations as a healthcare provider and its innovative software offerings as well as further geographic expansion. This will bring the benefits of its technology to millions more patients across Europe.

Kry, the European leader in digital healthcare whose technology connects patients with qualified healthcare professionals, will widen clinician access to its product suite. More healthcare professionals will have greater access to use Kry’s digital tools to deliver high-quality healthcare to patients across Europe. Beyond Kry’s core video consultation technology, which is already available in 30 European markets, clinicians will be able to access enhanced triage, advanced queuing and matching functionality, paperless referral management, secure patient messaging and personalised treatment plans.

Kry will continue to deepen the functionalities of its patient-facing app and expand its mental health offering to more markets including adding Internet Cognitive Behavioural Therapy (ICBT) and mental health self-assessment tools. Patients will be able to access a wider range of healthcare professionals such as psychologists, dermatologists, physiotherapists, and pediatricians. Furthermore, it will invest in digital healthcare tools to support chronic healthcare conditions.

Johannes Schildt, CEO and co-founder of Kry, said:

This investment will help us empower patients to make active choices about their health in partnership with thousands of public and private healthcare professionals in Europe.
Working in partnership with healthcare systems, governments, and clinicians, we can deliver high quality healthcare, improve patient access, and create healthier societies.
We have played a leading role in the digitization of healthcare across Europe and will continue to play a leading role in the creation of a global digital healthcare ecosystem to deliver better patient experiences and outcomes through our technology.

Leon Pedersen, Managing Director and Head of Thematic Investing, CPP Investments said:

Kry is a significant and successful player in Europe’s digital healthcare market and this investment is a strong fit with our innovations in healthcare strategy. We are pleased to support Kry as they leverage technology to advance the delivery of proactive patient-centric services.

Kry, which has been growing rapidly since it was founded in 2015, has helped over three million patients access healthcare to date. The company grew over 100% year-on-year in 2020 in response to supporting patients and healthcare systems across Europe during the pandemic. The new funding will help the company meet the increasing patient demand for their virtual healthcare services and fulfil its vision of making high-quality healthcare accessible for all.

Kry will also use the additional funding to grow its team and explore further acquisitions and strategic partnerships.

J.P. Morgan acted as Lead Placement Agent and Goldman Sachs acted as Placement Agent on the Series D round.

For further information please contact press@kry.health

We contacted and interviewed Roberta Sarno, Head of Digital Health at APACMed, to discuss the opportunities and challenges for the Digital Health in the APAC region.

Roberta Sarno Digital Health Manager, APACMed

Roberta joined APACMed in December 2019 to lead the new Digital Health Committee. She supports the association’s members to establish a digital health ecosystem, build knowledge and advocate for optimal policies that help digital health innovation in APAC.
Prior to joining APACMed, Roberta worked as senior consultant and business development manager at Alcimed in Paris and Marseille, France, where she supported clients in the healthcare sector on innovation and strategy projects. Before that, she worked as genetic engineering researcher at Curie Institute, in collaboration with the French startup Meiogenix.
She holds a PhD in genetics (Curie Institute, Paris), a master of business foundations (INSEAD) and lives in Singapore.

Asia Pacific: opportunities and challenges in healthcare

The demand for healthcare across APAC is growing rapidly, in both developed and emerging markets. This trend is mainly driven by population growth – with many emerging markets about to reach their “peak” population – and an ageing population. In addition to this, the lifestyle of a rising middle class has led to a surge in chronic diseases.
Healthcare solutions that are data driven, innovative and affordable, ones that re-imagine care and cost and focus on the patient are needed now more than ever before. While the technology has made great progress, providers, payers, and consumers have been slower to adopt than was anticipated, in part due to slow regulatory approvals and the lack of an adequate reimbursement model.
Having said that, the COVID-19 pandemic has been a catalyst in advancing some digital health solutions, specifically in remote patient care. However, challenges still remain: how remote care programs integrate along the continuum of care, how they qualify and quantify the value created to the total healthcare system, and how they can be scalable and sustainable.

Digital health innovations have undergone an unparalleled acceleration. Which solutions are impacting the most in the Asia Pacific region?

APAC is a very heterogeneous region, with different health systems, and various economic and political backgrounds. Despite the great heterogeneity, most of the APAC countries have seen unprecedent digital health acceleration in the past year. They rapidly introduced new technologies or increased the adopted of existing ones. A large number of technologies have allowed better and faster COVID-19 management: government chatbots dedicated to COVID-19, situation report dashboards with statistics and figures, official whatsapp accounts to inform citizens with timely and trusted updates, digital check in systems for contact tracing, telemedicine solutions to keep patients outside of the hospital, etc.
Among these solutions, some are expected to stay post-COVID-19. Telemedicine and remote care, for instance, are highly impacting the whole healthcare ecosystem. Companies are developing new solutions that patients and HCPs are increasingly using, governments are implementing new policies to ease access, and innovative partnerships are being formed among stakeholders. During covid, thousands of healthcare professionals have been trained to conduct telehealth visits with patients. Telemedicine platforms have also allowed patients in hospitals to communicate with their families. Now that both HCPs and patients have been forced to experiment the use of telemedicine, there are enough reasons to think they will keep this habit in the future.

Please tell us about APACMED, its mission and future initiatives such as ApacMed Digital Health Symposium 2021. What about the strategic topics addressed and the ecosystem involved?

Founded in 2014, the Asia Pacific Medical Technology Association (APACMed) represents manufacturers and suppliers of medical equipment, devices and in-vitro diagnostics, industry associations and other key stakeholders associated with the medical technology industry in Asia Pacific.
APACMed strives to improve access to high quality healthcare for patients, by working in close collaboration with regulators, policymakers, healthcare providers, payers and patients to develop policies and put forward recommendations that ensure optimal care pathways for patients, from diagnosis to treatment. The association supports innovative new technologies and start-ups that improve the quality of care and healthcare outcomes. It also drives common approaches aligned with international best practices promoting speed to access via common regulatory standards; security and efficiency to adopt new digital technologies; and ethical interactions with healthcare professionals through the adherence of the Code of Conduct.

Increasingly these discussions have taken shape around Digital Health, especially given the explosion of the topic during the COVID-19 pandemic. An official committee was formed in early 2020 to work on issues such as regulatory frameworks, cybersecurity, interoperability and reimbursement. Building on this momentum and to facilitate the acceleration of digital health, APACMed is organizing the inaugural edition of their Digital Health Symposium on May 4^th. It aims to bring together international and regional leaders to share learnings around use cases that have succeeded and discuss how Asia can accelerate the implementation of digital health solutions. The Symposium is conceived as a multi-step dialogue.
In May 2021, speakers will share valuable insights on reimbursement models and challenges to successful remote care management implementations to deliver better patient outcomes. In July, policymakers from the region will discuss priorities and challenges in a closed-door round table. The insights from these first two sessions will be shared during the annual APACMed MedTech Forum in September. More sessions will be held in 2022.

If you are coming to Helsinki from abroad by plane these days, you will be welcomed not only by the airport crew, but also the four-legged guardians: Finland is running a pilot program using dogs to detect passengers infected with Covid-19.

Different countries are performing research on the coronavirus-sniffing dogs, whose sharp noses have already made the headlines on Time, BBC and other media. However, Finland is the first in Europe to get to the actual trials at the airport: the project started at Helsinki-Vantaa airport at the end of September 2020, following Dubai International Airport that came up with the same innovation this summer.

The Finnish sniffing dogs working are trained by Wise Nose, Finland’s Smell Detection Association and Nose Academy, a start-up company responsible for operational activities at the airport. The research part is led by Anna Hielm-Bjorkman, Adjunct Professor of clinical research on companion animals at the University of Helsinki.

Digital Health Global talked to Soile Turunen, Project Planner at Nose Academy Oy, to shed some light (or sniff out the truth?) on the initiative.

Soile, behind every project there is a story. Could you share one about how it was discovered that dogs can detect Covid? How much time did it take to train the first dogs and to launch the project?

The idea came almost a year ago, in spring 2020 when the pandemic started to spread It belongs to Susanna Paavilainen, Executive Director at Wise Nose, and Anna Hielm-Bjorkman, professor at the Helsinki University.

Susanna is also a dog trainer, so she started to investigate whether her dog, Kössi, could sniff coronavirus. Susanna tried with some of the relatives and it turned out that the dog, in fact, could successfully detect Covid. Finland has been known for the low rates of coronavirus spread, hence it was even difficult to find enough positive samples for the training.

Susanna and Anna, with the support of the City of Vantaa Deputy Mayor, Timo Aronkytö, who found the idea innovative and noted a great potential for the country, started to work on the project mid of summer and managed to launch the dog training by August. Considering we are actively using the dogs now, we can say that the training takes 2-3 months but we need to keep in mind that we are still at a pilot stage, hence we don’t have enough data to estimate this time period in a more precise way.

Is there a specific dog breed that deals with such task better?

Most of the dogs we use have previous history of sniffing diseases – for example, Kössi, the dog of Susanna, was trained to detect cancer samples. In fact, Kössi has a history of his own: he is a mixed breed, he was found as a puppy in Spain and brought to Finland.

In general, any dog is capable of doing this kind of nose work. We have Labrador retrievers, German shepherds and White shepherds. The success of the dog depends more on his or her personality: it’s very important that a dog really enjoys the job! A dog should be enthusiastic about carrying out this kind of tasks. It’s crucial, the same as with people going to their job every day!

After a couple of weeks of training one can usually tell whether a dog would be capable of doing the task. At the moment we have 5 dogs working at a daily basis at the airport with 3 dogs under the training. One more dog is also working at the laboratory because not any dog is capable to do the job in the field – some get distracted with noises and people. We are renting the space at one of the schools in Vantaa where we have rooms for training, sample preparation and storage facilities, and dogs that need more peaceful environment work there.

It has beenclaimed that a dog’s ability to find positive patients is about 94-100 %. Can you already share some results of the pilot project? According to the earlier comments of Timo Aronkytö, less then 1% of passengers at the Helsinki airport turn out to be positive.

First of all, we always note that dogs don’t replace the PCR test, it’s a complementary method with a promising potential to screen people in a fast way.

We are advising all passengers who got tested by the dogs to take a PCR test as well, it is available for free for all foreign arrivals. In such way we can compare the results delivered by the dogs to the PCR results and it is also one of the scientific parts of the project. PCR is considered a gold standard right now, however, we know that it may also give false positive or false negative results – this is the puzzle we need to solve.

Our pilot project with the sniffing dogs was initially scheduled for 4 months, till the end of December 2020, but we already confirmed that we will continue in 2021. Until the official results are published by the beginning of the next year, I am not able to announce any percentage but I can say that in most of the times the results of the dogs are consistent with PCRs and we are very satisfied with the dogs.

It’s true that, luckily, a very slight percentage of arriving passengers is infected – in fact, we even give the dogs extra positive samples to sniff so that dog performs the odor separation between positive and negative ones often enough.

The pilot has been very important for us to figure out main logistics and operations details: how many dogs do we need, how much time can a dog spend at the airport vs the time for rest and so on. For example, we can currently screen around 100 customers per day.

By the way, after having finished the training, our dogs have an ‘internship’ phase at the airport before starting the actual work.

How do people react to the dogs? I can assume that not many are familiar with this project, especially the foreigners.

Everyone loves the dogs! The passengers, the Finavia crew – everyone comes to say hello and take pictures, we even started our Instagram account. I think it’s very important to have these positive and cheerful colleagues at the airport.

Turning to the comments of Timo again: he mentioned the costs of the program being equal to 300 000 euros which is relatively low compared to the cost of deploying other preventive measures against coronavirus. Is the whole project funded by the Finnish government?

Yes, mostly it is supported by the government and the City of Vantaa. was to build the facilities at the airport and employ eight people for this project. Then goes dogs training, and at Wise Nose we have rent, supplies, materials and also training costs for the people who work with the dogs.  We take a very good care of the dogs and starting next year we will make sure the dog owners have some resources for physiotherapy and other related costs.

As you can see, the project consists of 3 stakeholders: Wise Nose, which is responsible for the dog training, Nose Academy, where I work, responsible for operations and R&D represented by Anna from the University of Helsinki. Apart from state funding, Wise Nose gets donations from private persons  and companies such as Evidensia Veterinary services Ltd. The research team received contribution from the Finnish Kennel Club.

Are you planning to share your experience with other countries considering that Finland is pioneering Europe?

Indeed, we are contacted by many researchers and right now keeping contact with more than 10 countries. I know that France and Germany have done some research in the area, Italy and Spain are also discussing about dog training and usage of the sniffer dog. We are willing to help, however we have quite limited number of people working on this project so we cannot allocate too much time for this experience transfer.

We started thinking on how we can share our takeaways from the pilot project and first, we thought about hosting research groups from other countries that could come for a week or two to Finland when epidemiological situation in Europe gets better. Then, we also came up with the idea to record videos of the training. It could be a scalable option, but the limitation here is that each dog is very individual: you record the training video with the one and then the next dog would be different.

This year, Frontiers has been a global Hybrid conference. In line with the “new normal” situation, the format of the 2020 edition has been hybrid, combining online global streaming together with offline events and activities held at hubs in multiple locations such as Italy, Germany, Finland, Spain, the USA, Switzerland and more.

It has been dedicated to digital health innovation in the context of the “new normal”, focusing on telemedicine, digital therapies, breakthrough technologies, patient-centricity, healthcare transformation and ecosystem development.

You can read the full live coverage on the pharmaphorum dedicated pages: Day 1 – Day 2

MRC Epidemiology Unit launches study to monitor COVID-19 in 12,000 Cambridgeshire residents – MRC Epidemiology Unit

SAFE2GO Contact Tracing App to Help UK Businesses Open Safely – digit.fyi

Emotional empathy is driving brand equity – pharmaphorum

Smell and taste loss could help identify COVID-19 at airports, say researchers – pharmaphorum

HealthTunes launches iOS APP to deliver stress and anxiety relief to healthcare workers and beyond – Healthware Group

European investment and regulation

The fast-tracking of global regulations on digital health has enabled wide roll-outs of solutions and in turn encouraged greater investment into the sector. European companies operating in the space have raised $11.8 billion, with France playing a leading role, both on the investors’ and funded companies’ side^[1].
We all know that reimbursement is a key challenge for many new digital health solutions. Since late last year Germany’s Digital Healthcare Act (Digitale–Versorgung–Gesetz) started to chart an important course for other European countries, even though some issues are yet to be resolved^[2].
Consequently, the pandemic period has seen France reimburse its first digital therapy in the form of Sivan’s Moovcare, which targets lung cancer^[3], while Belgium recently fully reimbursed moveUP, an mHealth app for the follow-up of patients after hip and knee replacement operations^[4].

Partnerships

On the companies’ side we have witnessed the establishment of a number of promising partnerships between digital health firms and pharma companies or other institutions.
One of these is a collaboration between Kaiku Health and Roche to co-develop novel digital patient monitoring and management modules in oncology.
The renewed partnership linking mobile care coordination and patient engagement platform Buddy Healthcare with Tampere University Hospital is another example, and will see Tampere implement Buddy’s platform to streamline its patient services and provide transparent and clear care pathways^[5].

Mental Health

The field’s next steps will be ensuring digital health is used today to deliver the best care to a global population in face of a mental health spike following the global emergency.
Digital therapy programmes that can offer courses of evidence-based treatments also have a role in the crisis, given their unique potential for scalability. In the first half of 2020, digital behavioural health start-ups scored $588 million, roughly the annual funding for this segment in any previous year^[6].