COVID Symptom Study
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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 smartphone, phone, tablet computer, tablet, or smartwatch, watch. Mobile applications often stand in contrast to desktop appli ...
that runs on Android and
iOS Ios, Io or Nio (, ; ; locally Nios, Νιός) is a Greek island in the Cyclades group in the Aegean Sea. Ios is a hilly island with cliffs down to the sea on most sides. It is situated halfway between Naxos and Santorini. It is about long an ...
. The app was created in 2020 in response to the
COVID-19 pandemic The COVID-19 pandemic (also known as the coronavirus pandemic and COVID pandemic), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), began with an disease outbreak, outbreak of COVID-19 in Wuhan, China, in December ...
, in a collaboration between Zoe,
King's College London King's College London (informally King's or KCL) is a public university, public research university in London, England. King's was established by royal charter in 1829 under the patronage of George IV of the United Kingdom, King George IV ...
, Guy's and
St Thomas' Hospital St Thomas' Hospital is a large NHS teaching hospital in Central London, England. Administratively part of the Guy's and St Thomas' NHS Foundation Trust, together with Guy's Hospital, Evelina London Children's Hospital, Royal Brompton Hospita ...
s with funding granted by the UK government until April 2022. The 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.


Timeline

The idea for an app to track the spread of COVID-19 came from
Tim Spector Timothy David Spector (born 1958) is a British epidemiologist, medical doctor, and science writer, working on the relationship between nutrition, the gut microbiome, and health. He argues against low-fat diets and fad diets,King's College London King's College London (informally King's or KCL) is a public university, public research university in London, England. King's was established by royal charter in 1829 under the patronage of George IV of the United Kingdom, King George IV ...
. 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 i ...
; this research was in collaboration with
Massachusetts General Hospital Massachusetts General Hospital (Mass General or MGH) is a teaching hospital located in the West End neighborhood of Boston, Massachusetts. It is the original and largest clinical education and research facility of Harvard Medical School/Harvar ...
. The project website states that ZOE COVID Study data provided will not be sold (aggregate data from wider Zoe health studies research may be used by Zoe to develop commercial health products). The project also collaborated with the Outbreaks Near Me platform based out of
Harvard Medical School Harvard Medical School (HMS) is the medical school of Harvard University and is located in the Longwood Medical and Academic Area, Longwood Medical Area in Boston, Massachusetts. Founded in 1782, HMS is the third oldest medical school in the Un ...
and
Boston Children's Hospital Boston Children's Hospital (formerly known as Children's Hospital Boston until 2013) is the main pediatric training and research hospital of Harvard Medical School, Harvard University. It is a nationally ranked, freestanding acute care children ...
. The app was released as a trial for 5,000
twins Twins are two offspring produced by the same pregnancy.MedicineNet > Definition of Twin Last Editorial Review: 19 June 2000 Twins can be either ''monozygotic'' ('identical'), meaning that they develop from one zygote, which splits and forms two e ...
, 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 marketplace developed and maintained by Apple, 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 SDK. Apps can be download ...
and
Google Play Store Google Play, also known as the Google Play Store, Play Store, or sometimes the Android Store (and was formerly Android Market), is a digital distribution service operated and developed by Google. It serves as the official app store for certifie ...
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 ministerial department of the Government of the United Kingdom. It is responsible for government policy on health and adult social care matters in England, along with a few elements of the s ...
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 responsible for all health security in England, and some reserved public health protection matters across the whole of the United Kingdom. It is an executive agency of the Department ...
) 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. 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 (also known as chronic disease or chronic illness) 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 ...
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 virus, viral infectious disease of the upper respiratory tract that primarily affects the Respiratory epithelium, respiratory mucosa of the human nose, nose, throat, Paranasal sinuses, sinuses, and larynx. ...
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 sympto ...
. The app does not have any
contact tracing In public health, contact tracing is the process of identifying people 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 discipline that builds and organises knowledge in the form of testable hypotheses and predictions about the universe. Modern science is typically divided into twoor threemajor branches: the natural sciences, which stu ...
'' on 5 May 2020 and in ''
Nature Medicine ''Nature Medicine'' is a monthly 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 into disease p ...
'' 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.


Zoe Limited

Zoe Limited also provides in the US and UK, as a separate product, a "personalized nutrition program" whereby the company supplies sensors to quantify a person's
gut microbiome Gut microbiota, gut microbiome, or gut flora are the microorganisms, including bacteria, archaea, fungi, and viruses, that live in the digestive tracts of animals. The gastrointestinal metagenome is the aggregate of all the genomes of the g ...
, blood fat, and
blood sugar The blood sugar level, blood sugar concentration, blood glucose level, or glycemia is the measure of glucose concentrated in the blood. The body tightly regulates blood glucose levels as a part of metabolic homeostasis. For a 70 kg (1 ...
responses to food intake, alongside an app which uses this data to recommend
dietary In nutrition, diet is the sum of food consumed by a person or other organism. The word diet often implies the use of specific intake of nutrition for health or weight-management reasons (with the two often being related). Although humans are ...
modifications.


See also

* NHS COVID-19


References


Further reading

*


External links

* {{COVID-19 pandemic in the United Kingdom, Crown Dependencies and British Overseas Territories Software associated with the COVID-19 pandemic Scientific and technical responses to the COVID-19 pandemic 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 Nutrition in the United Kingdom United Kingdom responses to the COVID-19 pandemic