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BACKGROUND: The Pfizer-BioNTech COVID-19 vaccine uses a novel messenger RNA technology to elicit a protective immune response. Short-term physiologic responses to the vaccine have not been studied using wearable devices. OBJECTIVE: We aim to characterize physiologic changes in response to COVID-19 vaccination in a small cohort of participants using a wearable device (WHOOP Strap 3.0). This is a proof of concept for using consumer-grade wearable devices to monitor response to COVID-19 vaccines. METHODS: In this prospective observational study, physiologic data from 19 internal medicine residents at a single institution that received both doses of the Pfizer-BioNTech COVID-19 vaccine was collected using the WHOOP Strap 3.0. The primary outcomes were percent change from baseline in heart rate variability (HRV), resting heart rate (RHR), and respiratory rate (RR). Secondary outcomes were percent change from baseline in total, rapid eye movement, and deep sleep. Exploratory outcomes included local and systemic reactogenicity following each dose and prophylactic analgesic use. RESULTS: In 19 individuals (mean age 28.8, SD 2.2 years; n=10, 53% female), HRV was decreased on day 1 following administration of the first vaccine dose (mean -13.44%, SD 13.62%) and second vaccine dose (mean -9.25%, SD 22.6%). RHR and RR showed no change from baseline after either vaccine dose. Sleep duration was increased up to 4 days post vaccination, after an initial decrease on day 1. Increased sleep duration prior to vaccination was associated with a greater change in HRV. Local and systemic reactogenicity was more severe after dose two. CONCLUSIONS: This is the first observational study of the physiologic response to any of the novel COVID-19 vaccines as measured using wearable devices. Using this relatively small healthy cohort, we provide evidence that HRV decreases in response to both vaccine doses, with no significant changes in RHR or RR. Sleep duration initially decreased following each dose with a subsequent increase thereafter. Future studies with a larger sample size and comparison to other inflammatory and immune biomarkers such as antibody response will be needed to determine the true utility of this type of continuous wearable monitoring in regards to vaccine responses. Our data raises the possibility that increased sleep prior to vaccination may impact physiologic responses and may be a modifiable way to increase vaccine response. These results may inform future studies using wearables for monitoring vaccine responses. TRIAL REGISTRATION: ClinicalTrials.gov NCT04304703; https://www.clinicaltrials.gov/ct2/show/NCT04304703.
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The task induced blood oxygenation level dependent signal changes observed using functional magnetic resonance imaging (fMRI) are critically dependent on the relationship between neuronal activity and hemodynamic response. Therefore, understanding the nature of neurovascular coupling is important when interpreting fMRI signal changes evoked via task. In this study, we used regional homogeneity (ReHo), a measure of local synchronization of the BOLD time series, to investigate whether the similarities of one voxel with the surrounding voxels are a property of neurovascular coupling. FMRI scans were obtained from fourteen subjects during bilateral finger tapping (FTAP), digit-symbol substitution (DSST) and periodic breath holding (BH) paradigm. A resting-state scan was also obtained for each of the subjects for 4min using identical imaging parameters. Inter-voxel correlation analyses were conducted between the resting-state ReHo, resting-state amplitude of low frequency fluctuations (ALFF), BH responses and task activations within the masks related to task activations. There was a reliable mean voxel-wise spatial correlation between ReHo and other neurovascular variables (BH responses and ALFF). We observed a moderate correlation between ReHo and task activations (FTAP: r=0.32; DSST: r=0.22) within the task positive network and a small yet reliable correlation within the default mode network (DSST: r=-0.08). Subsequently, a linear regression was used to estimate the contribution of ReHo, ALFF and BH responses to the task activated voxels. The unique contribution of ReHo was minimal. The results suggest that regional synchrony of the BOLD activity is a property that can explain the variance of neurovascular coupling and task activations; but its contribution to task activations can be accounted for by other neurovascular factors such as the ALFF.