Monitoring Symptoms of Infectious Diseases: Perspectives for Printed Wearable Sensors

Abstract

Infectious diseases possess a serious threat to the world's population, economies, and healthcare systems. In this review, we cover the infectious diseases that are most likely to cause a pandemic according to the WHO (World Health Organization). The list includes COVID-19, Crimean-Congo Hemorrhagic Fever (CCHF), Ebola Virus Disease (EBOV), Marburg Virus Disease (MARV), Lassa Hemorrhagic Fever (LHF), Middle East Respiratory Syndrome (MERS), Severe Acute Respiratory Syndrome (SARS), Nipah Virus diseases (NiV), and Rift Valley fever (RVF). This review also investigates research trends in infectious diseases by analyzing published research history on each disease from 2000-2020 in PubMed. A comprehensive review of sensor printing methods including flexographic printing, gravure printing, inkjet printing, and screen printing is conducted to provide guidelines for the best method depending on the printing scale, resolution, design modification ability, and other requirements. Printed sensors for respiratory rate, heart rate, oxygen saturation, body temperature, and blood pressure are reviewed for the possibility of being used for disease symptom monitoring. Printed wearable sensors are of great potential for continuous monitoring of vital signs in patients and the quarantined as tools for epidemiological screening.

Keywords: blood pressure; heart rate; infectious diseases; inkjet printing; pulse oximeter; respiratory rate; screen printing; wearable sensors.

Figure 1

Statistics on publications for each disease for the period of 2000–2020, (Source: PubMed search results; search terms: “COVID–19”, “severe acute respiratory syndrome”, “middle east respiratory syndrome”, “ebola virus disease”, “rift valley fever”, “Crimean-Congo hemorrhagic fever”, “nipah virus”, “lassa fever”, “marburg virus disease”). (a) Number of publications mentioning each disease from the year 2000 to 2020; COVID-19 shows an unprecedented spike. (b) Percentage of published research on each disease after normalization during five four-year periods to show the periods at which certain topics received the highest interest.

Figure 2

Summary of modes of transmission, symptoms, and clinical management for the infectious diseases mentioned in this study. Symptoms are categorized into three categories: respiratory, digestive, and nervous.

Figure 3

A summary of the printing methods described above (gravure, flexographic, screen, and inkjet printing). Step (A) represents the substrate preparation, step (B) shows the feature realization needed to transfer the design from the carrier, step (C) illustrates the process of different printing methods, step (D) shows the sintering process were solvents evaporate and the sold components of the ink remain, and Step (E) shows the finished printed sensor. Steps (A,D,E) are usually common in all printing techniques.

Figure 4

Selected printed wearable temperature sensors. (I) Inkjet-printed PEDOT:PSS sensor by Wang et al. [223] used under the terms of Creative Commons Attribution 4.0 International license, (II) Wrist carbon-based temperature sensor by Ali et al. [224] used under the terms of Creative Commons Attribution 4.0 International license, (III) Resistive PEDOT:PSS sensor fixed on a watch-style band by Han et al. [227] used under the terms of Creative Commons Attribution Non-Commercial License, and (IV) Resistive chest CNT sensor by Yamamoto et al. Reused with permission [226,228] Copyright (2017), John Wiley and Sons.

Figure 5

Selected printed respiratory rate sensors. (I) the inkjet-printed strain gauge sensor, along with a reference airflow sensor for results validation [184,255,256], used under the terms of Creative Common CC BY license. (II) Gold nanoparticles humidity sensor embedded in a facemask, reused with permission [261]. Copyright (2019) American Chemical Society.

Figure 6

Printed heart rate and oxygen saturation sensors. (I) shows the screen-printed ECG sensor on TPU film; the left figure shows the placement of the 4 electrodes, while the figure on the right shows a volunteer wearing the device; reused with permission from [279], Copyright (2019), John Wiley & Sons. (II) shows the inkjet-printed pulse oximeter while performing live monitoring on a human subject [188], used under the terms of Creative Common CC BY license.

Figure 7

Printed blood pressure monitoring devices from the literature. (I) Strain gauges sensor by Wang et al. [294] showing CULM and strain sensor, (II) displacement simulation on the skin as a result of the actuation force. Reused with permission, Copyright (2016), Elsevier.