Long COVID & Wearable Devices

Integrating Fitbit data with EHR to study post-COVID outcomes

Overview

Investigating the relationship between pre-infection physical activity levels and Long COVID risk using integrated wearable device and electronic health record data from the All of Us Research Program.

Key Finding

Higher step counts before COVID-19 infection are associated with reduced risk of developing Long COVID symptoms.

This research demonstrates the value of integrating passively-collected wearable device data with clinical outcomes to understand post-viral syndromes.

Methods

  • Linked Fitbit activity data with COVID-19 diagnoses from EHR
  • Defined Long COVID using validated phenotyping algorithms
  • Adjusted for demographics, comorbidities, and COVID severity
  • Applied propensity score methods to address confounding

Significance

This study represents one of the first large-scale analyses combining:

  • Objective physical activity measures (not self-reported)
  • Validated clinical outcomes from EHR data
  • Diverse population from the All of Us cohort

Presentation

Waxse BJ, et al. Higher Step Count is Associated with Reduced Risk of Long COVID. IDWeek 2025, Podium Presentation (Accepted).

Implications

Findings suggest that maintaining physical activity may have protective effects against Long COVID, with potential implications for:

  • Public health messaging during respiratory virus seasons
  • Rehabilitation strategies for COVID-19 survivors
  • Understanding the pathophysiology of post-viral fatigue syndromes