Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the current pandemic, and as of August 2022 has led to about 590 million infections. Upon infection, patients can develop coronavirus disease 2019 (COVID-19) ranging from asymptomatic disease to severe disease leading to hospitalization and, in some patients, death. About 5-20% of COVID-19 patients do not recover from acute illness and experience long-term symptoms. This condition is commonly referred to as long COVID and is increasingly recognized as an emerging burden for both patients and the healthcare system. The most frequent symptoms include fatigue, dyspnea, cognitive impairment, and Post Excertional Malaise (PEM). Although long Covid manifests as heterogenous disease, it shows many similarities to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a condition affecting about 1% of the total population. Nevertheless, both patient subsets have in common that they can suffer from debilitating fatigue, PEM, and exhaustion, triggered by physical activity. A common strategy applied by patients to avoid so called “crashes” is activity pacing.

Activity pacing is a common form of energy management, which allows individuals to limit (i.e. “pace”) their activity (e.g. heart rate, number of steps, number of stairs, etc.) to a specific level or predefined goal, and avoid exhaustion. Activity monitoring during physical activities (sports, work, household) provides biofeedback that promotes symptom awareness and control, and helps to avoid exertion and overtaxing one’s body. Thus, pacing can be useful for various scenarios, e.g. in pain management, for sports training, and also people suffering from long COVID or ME/CFS.

While many patients perform manual pacing (i.e. without any aids), some have started using activity trackers, such as the Fitbit or Garmin wristwatches that can be easily brought with them everywhere and provide reliable (but not medical grade) measurements, such as heart rate, number of steps, and blood oxygen saturation.

However, we have not yet been able to identify an activity pacing app that is flexible enough to let users set multiple activity pacing goals. Therefore, our aim is to evaluate if we can develop an activity pacing app that is useful for people who need to manage their energy.

In a first phase, we evaluate the feasibility to develop such an app, based on inputs from potential users and patients. Should it proof possible to develop such an app, we will continue the project in phase 2 to adapt the app specifically to long COVID and ME/CFS patients and evaluate the usefulness.

The goal and scope of this Master Project is defined as follows:

• Identify patient needs (with support from a Long Covid expert, Dr. med. Carlo Cervia, at USZ)
• Develop pacing apps for Garmin and Fitbit that provide alerts
  to users based on their individual activities and preferences
• Evaluate the apps with healthy users
• (if interested) Support the preparation of a field study with real patients

The project is ideal for 2 (max 3) students.