Objective:

To evaluate the accuracy, validity, reliability, and clinical utility of consumer wearable devices for monitoring post–acute sequelae of SARS-CoV-2 infection (PASC) and related syndromes.

Approach:

• Systematic Umbrella Review: Investigators conducted a preregistered systematic umbrella review, analyzing 42 eligible reviews from 3,988 records, covering over 30 wearable brands and more than 150 device series.

Key Findings:

• Heart rate monitoring had the largest evidence base, with variable but generally favorable performance compared to clinical-grade standards.
• Atrial fibrillation detection showed moderate-to-high accuracy across devices, with Samsung devices achieving sensitivity up to 97%.
• Step-count accuracy varied significantly across devices and populations, particularly in patients with slower gait speeds.
• Energy expenditure estimates generally showed low or inconsistent accuracy.
• Substantial gaps in evidence were identified for several biomarkers, including oxygen saturation and skin temperature.
• No review-level evidence demonstrated that wearable monitoring improves morbidity or health care utilization in PASC patients.

Interpretation:

Evidence supporting consumer wearable use in PASC is limited, with heart rate monitoring and atrial fibrillation detection being the most validated applications.

Limitations:

• Review quality was variable, with many reviews not meeting AMSTAR 2.0 quality criteria.
• Most evidence derived from medically healthy populations rather than those with PASC.
• Device performance varied by age, skin tone, gait speed, health status, and setting.
• No evidence addressing adverse effects associated with wearable use.

Conclusion:

There is insufficient evidence to recommend consumer wearables for self-monitoring in individuals with PASC and related syndromes.

Sources:

• PLOS Digital Health