Free-living core body temperature monitoring using a wrist-worn sensor after COVID-19 booster vaccination: a pilot study.

Core body temperature (CBT) is a key vital sign and fever is an important indicator of disease. In the past decade, there has been growing interest for vital sign monitoring technology that may be embedded in wearable devices, and the COVID-19 pandemic has highlighted the need for remote patient monitoring systems. While wrist-worn sensors allow continuous assessment of heart rate and oxygen saturation, reliable measurement of CBT at the wrist remains challenging. In this study, CBT was measured continuously in a free-living setting using a novel technology worn at the wrist and compared to reference core body temperature measurements, i.e., CBT values acquired with an ingestible temperature-sensing pill. Fifty individuals who received the COVID-19 booster vaccination were included. The datasets of 33 individuals were used to develop the CBT prediction algorithm, and the algorithm was then validated on the datasets of 17 participants. Mean observation time was 26.4 h and CBT > 38.0 °C occurred in 66% of the participants. CBT predicted by the wrist-worn sensor showed good correlation to the reference CBT (r = 0.72). Bland-Altman statistics showed an average bias of 0.11 °C of CBT predicted by the wrist-worn device compared to reference CBT, and limits of agreement were - 0.67 to + 0.93 °C, which is comparable to the bias and limits of agreement of commonly used tympanic membrane thermometers. The small size of the components needed for this technology would allow its integration into a variety of wearable monitoring systems assessing other vital signs and at the same time allowing maximal freedom of movement to the user.

Wearable Technologies for Pediatric Patients with Surgical Infections-More than Counting Steps?

Reliable vital sign assessments are crucial for the management of patients with infectious diseases. Wearable devices enable easy and comfortable continuous monitoring across settings, especially in pediatric patients, but information about their performance in acutely unwell children is scarce. Vital signs were continuously measured with a multi-sensor wearable device (Everion®, Biofourmis, Zurich, Switzerland) in 21 pediatric patients during their hospitalization for appendicitis, osteomyelitis, or septic arthritis to describe acceptance and feasibility and to compare validity and reliability with conventional measurements. Using a wearable device was highly accepted and feasible for health-care workers, parents, and children. There were substantial data gaps in continuous monitoring up to 24 h. The wearable device measured heart rate and oxygen saturation reliably (mean difference, 2.5 bpm and 0.4% SpO2) but underestimated body temperature by 1.7 °C. Data availability was suboptimal during the study period, but a good relationship was determined between wearable device and conventional measurements for heart rate and oxygen saturation. Acceptance and feasibility were high in all study groups. We recommend that wearable devices designed for medical use in children be validated in the targeted population to assure future high-quality continuous vital sign assessments in an easy and non-burdening way.

Immune thrombocytopenia associated with COVID-19 mRNA vaccine tozinameran - a clinical case and global pharmacovigilance data.

We report the occurrence of immune thrombocytopenia (ITP) in a 77-year-old man a few days after receiving the first dose of the COVID-19 mRNA vaccine tozinameran (Comirnaty®). The patient was treated with systemic corticosteroids, intravenous immunoglobulins and eltrombopag. He elected to proceed with the second dose of tozinameran 14 weeks after the first and his platelet count remained stable under a tapered eltrombopag dose. To our knowledge, this is the first case in which a second tozinameran dose has been administered to a patient who developed presumed secondary ITP after the first vaccination. We also report global pharmacovigilance data for the occurrence of ITP after vaccination with tozinameran.