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The Zoe Health Study, formerly the COVID Symptom Study, is a health research project of British company Zoe Limited (formerly Zoe Global limited) which uses a
mobile app A mobile application or app is a computer program or software application designed to run on a mobile device such as a phone, tablet, or watch. Mobile applications often stand in contrast to desktop applications which are designed to run on d ...
that runs on Android and
iOS iOS (formerly iPhone OS) is a mobile operating system created and developed by Apple Inc. exclusively for its hardware. It is the operating system that powers many of the company's mobile devices, including the iPhone; the term also includes ...
. The app was created in 2020 in response to the
COVID-19 pandemic The COVID-19 pandemic, also known as the coronavirus pandemic, is an ongoing global pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The novel virus was first identif ...
, in a collaboration between Zoe,
King's College London King's College London (informally King's or KCL) is a public research university located in London, England. King's was established by royal charter in 1829 under the patronage of King George IV and the Duke of Wellington. In 1836, King's ...
, Guy's and
St Thomas' Hospital St Thomas' Hospital is a large NHS teaching hospital in Central London, England. It is one of the institutions that compose the King's Health Partners, an academic health science centre. Administratively part of the Guy's and St Thomas' NHS Foun ...
s. with funding granted by the UK government until April 2022. The initial purpose of the app was to track COVID-19 symptoms and other salient data in a large number of people, to enable epidemiological results to be calculated. In 2022 the scope of the study was broadened to include other widespread health concerns such as cancer, high blood pressure and heart disease. Zoe Limited also provides in the US and UK, as a separate product, a system that allows people to analyse their unique gut, blood fat and blood sugar responses to food, saying that it enables people to "make the best decisions for your own health & weight goals".


Timeline

The idea for an app to track the spread of COVID-19 came from professor
Tim Spector Timothy David Spector (born 1958) is a British epidemiologist, medical doctor, and science writer. Biography Spector was born in North London in July 1958. He trained in medicine and rose to the position of consultant rheumatologist, before ...
, an epidemiologist at
King's College London King's College London (informally King's or KCL) is a public research university located in London, England. King's was established by royal charter in 1829 under the patronage of King George IV and the Duke of Wellington. In 1836, King's ...
. In the early months of 2020 he used his startup company ZOE Global Limited to build a Covid Symptom Tracker app in collaboration with King's College London and Guy's and St Thomas' hospitals. By May 2020 the app's name had changed to COVID Symptom Study. Initially the project was UK-based, where there is open membership. In the United States at a later date various cohorts from existing studies were added, including from the
Nurses' Health Study The Nurses Health Study is a series of prospective studies that examine epidemiology and the long-term effects of nutrition, hormones, environment, and nurses' work-life on health and disease development. The studies have been among the largest inv ...
; this research was in collaboration with
Massachusetts General Hospital Massachusetts General Hospital (Mass General or MGH) is the original and largest teaching hospital of Harvard Medical School located in the West End neighborhood of Boston, Massachusetts. It is the third oldest general hospital in the United Stat ...
. The project website states that "The app is and always will be free, and any data you provide will not be used for commercial purposes." The app was released as a trial for 5,000
twins Twins are two offspring produced by the same pregnancy.MedicineNet > Definition of TwinLast Editorial Review: 19 June 2000 Twins can be either ''monozygotic'' ('identical'), meaning that they develop from one zygote, which splits and forms two em ...
, using patients involved in other Zoe research projects. It was later expanded for use by non-twins. The app entered the UK
Apple App Store The App Store is an app store platform, developed and maintained by Apple Inc., for mobile apps on its iOS and iPadOS operating systems. The store allows users to browse and download approved apps developed within Apple's iOS Software Deve ...
and
Google Play Store Google Play, also known as the Google Play Store and formerly the Android Market, is a digital distribution service operated and developed by Google. It serves as the official app store for certified devices running on the Android operating sys ...
on 24 March, and the US App and Play stores on 29 March. At the end of April 2020, the project received assistance from the
Department of Health and Social Care The Department of Health and Social Care (DHSC) is a department of His Majesty's Government responsible for government policy on health and adult social care matters in England, along with a few elements of the same matters which are not otherwis ...
which allowed it to offer up to 10,000 COVID-19 tests each week to participants. In August 2020, the UK government made a grant of £2million to support data collection by the project, and by August 2021, government funding amounted to £5m. In May 2021, the associated company name was changed from ZOE Global Limited to ZOE Limited. Government funding (latterly via the
UK Health Security Agency The UK Health Security Agency (UKHSA) is a government agency in the United Kingdom, responsible since April 2021 for England-wide public health protection and infectious disease capability, and replacing Public Health England. It is an executiv ...
) ceased at the end of March 2022. In May 2022, ZOE announced that the name of the study would change to ZOE Health Study, to reflect its use in logging symptoms extending beyond those of COVID-19.


Uptake

Within 24 hours of being available in the UK, the app had been downloaded over 1 million times. A paper using data collected in the four weeks up to 21 April 2020 analysed symptoms from 2.45million people in the UK and 168,000 in the US. As of May 2020, the app had been downloaded by over 3 million people, including 2 million Britons. By 17 July the number exceeded 4 million. The number of active app users is not published. In late October 2020, Spector said that a million users were reporting symptoms most days. Researchers who analysed data collected in the last three months of 2020 said they used more than 65 million health reports from 1.76 million users. By July 2021, the app had been used by 4.6million people in Britain and about a quarter of that number continued to self-report every day.


Research

The COVID Symptom Study requires users to give their location. Users give personal information including age, gender and location, and report if they have any underlying
chronic condition A chronic condition is a health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term ''chronic'' is often applied when the course of the disease lasts for more than three mo ...
s. They also answer questions related to common COVID-19 symptoms, and input any illness or symptoms that they have, as well as stating whether they have been tested for COVID-19. Beginning in May 2020, a random sample of users is selected (on the first day they report symptoms) for a swab test. Researchers then use statistical analysis to determine which symptoms are likely to indicate COVID-19, rather than the
common cold The common cold or the cold is a viral infectious disease of the upper respiratory tract that primarily affects the respiratory mucosa of the nose, throat, sinuses, and larynx. Signs and symptoms may appear fewer than two days after exposu ...
or seasonal
influenza Influenza, commonly known as "the flu", is an infectious disease caused by influenza viruses. Symptoms range from mild to severe and often include fever, runny nose, sore throat, muscle pain, headache, coughing, and fatigue. These symptoms ...
. The app does not have any
contact tracing In public health, contact tracing is the process of identifying persons who may have been exposed to an infected person ("contacts") and subsequent collection of further data to assess transmission. By tracing the contacts of infected individua ...
functionality. Based on the data inputted into the app, researchers estimated that when cases peaked on 1 April 2020, 2.1 million people in the UK aged between 20 and 69 may have had COVID-19, and that as of 23 May 2020, 280,000 people in that age range currently had symptoms consistent with COVID-19. The study also estimates the risk level to health workers, compared with the general public. Research based on the app was described in papers in ''
Science Science is a systematic endeavor that builds and organizes knowledge in the form of testable explanations and predictions about the universe. Science may be as old as the human species, and some of the earliest archeological evidence for ...
'' on 5 May 2020 and in ''
Nature Medicine ''Nature Medicine'' is a monthly Peer review, peer-reviewed medical journal published by Nature Portfolio covering all aspects of medicine. It was established in 1995. The journal seeks to publish research papers that "demonstrate novel insight int ...
'' on 11 May 2020. Using data from the app, researchers were able to identify six distinct types of COVID-19 and forecast which initial symptoms were more likely to lead to severe illnesses.


See also

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NHS COVID-19 NHS COVID-19 is a voluntary contact tracing app for monitoring the spread of the COVID-19 pandemic in England and Wales. It has been available since 24 September 2020 for Android and iOS smartphones, and can be used by anyone aged 16 or ove ...


References


External links

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App at Google Play

App at Apple's App Store
{{COVID-19 pandemic in the United Kingdom, Crown Dependencies and British Overseas Territories Software associated with the COVID-19 pandemic apps 2020 establishments in the United Kingdom COVID-19 pandemic in the United Kingdom 2020 software Android (operating system) software IOS software King's College London United Kingdom responses to the COVID-19 pandemic