JMIR Publications

ABSTRACT

Background:

The COVID-19 symptom monitoring apps provide direct feedback to users about the suspected risk of infection with SARS-CoV-2 and advice on how to proceed to prevent the spread of the virus. We have developed the CoronaCheck mobile health platform, the first free app that provides easy access to valid information about the risk of infection with SARS-CoV-2 in English and German. Previous studies suggested that clinical characteristics of individuals infected with SARS-CoV-2 vary by age, gender, and viral variant; however, potential differences between countries have not been adequately studied.

Objective:

The aim of this study was to describe country-specific and sociodemographic associations of COVID-19-related symptoms and previous contacts with COVID-19-infected individuals reported by users of the CoronaCheck mobile health platform.

Methods:

Between April 8, 2020, and February 3, 2022, data on sociodemographic characteristics, symptoms, and reports of previous close contact with COVID-19 infected individuals were collected from CoronaCheck users in different countries. Multivariable logistic regression analyses were used to examine whether self-reports of COVID-19-related symptoms and recent contact with a person infected with COVID-19 differed between countries (Germany, India, South Africa), gender-identities, age groups, education, and calendar year.

Results:

Most app users were from Germany (n=8,116), India (n=6,622), and South Africa (n=3,705). Most data were collected in 2020 (85.1%). Sixty four percent of users were male, 52.1% were ≥30 years old, and 38.6% had an education level of more than 11 years schooling. Fever, loss of smell, and loss of taste were reported more frequently by users in India (adjusted odds ratio 4.4-7.1) and South Africa (2.3-2.6) than those in Germany. General weakness, shortness of breath, and muscle pain were more frequently reported in India (1.9-2.6) compared to Germany. The gender-diverse users reported symptoms and contacts with confirmed COVID-19-cases more often compared to male users.

Conclusions:

Patterns of self-reported COVID-19-related symptoms and awareness of a previous contact with COVID-19-infected individuals seemed to differ between India, South Africa, and Germany, as well as by gender-identity in these countries. Viral symptom collecting apps, such as the CoronaCheck mobile health platform, may be promising tools for pandemics to support appropriate assessments. Future mHealth research on country-specific differences during a pandemic should aim to recruit representative samples.