Long COVID Diary: A User Centered Approach for the Design of a

Mobile Application Supporting Long COVID Patients

Andreas Hausberger, Barbara Tappeiner

, Ren

e Baranyi

and Thomas Grechenig

Institute of Information Systems Engineering, Research Group for Industrial Software (INSO), TU Wien, Austria

Keywords:

Long COVID, Patient Journey, Mobile Application, Survey, User Centered Design.

Abstract:

A signiﬁcant part of patients who have recovered from COVID-19 has been experiencing COVID-like symp-

toms for weeks and months after the initial disease. These patients have been called “Long COVID patients”.

Currently, guidelines are being published that inform about these symptoms and may deliver a basis for medi-

cal diagnoses. In this paper, the possibility of a Long COVID patient support app is being discussed. To gain

insight into the needs and requirements of patients with Long COVID, a questionnaire was conducted with

193 participants from a self help-group in Austria. The results show that Long COVID has a profound nega-

tive impact on the daily lives of people who are suffering from the disease. Also, the results show a demand

for more support and indicate the role that a Long COVID symptom tracking app could play in this context.

Concerning digital support, ten crucial features of a potential Long COVID support app were identiﬁed by

analyzing the answers to the questionnaire. Apart from health and symptom tracking features, sharing of data

with medical professionals, appointment management, and news features were considered important features

to support patients suffering from Long COVID throughout their journey to get better.

1 INTRODUCTION

Since the beginning of 2020, the COVID-19 pan-

demic has fundamentally impacted and changed

many aspects of our society. Due to the disease’s high

contagiousness, many countries have engaged in re-

peated lockdown periods and tried to enforce social

distancing. Despite these efforts, millions of peo-

ple worldwide and hundreds of thousands of people

in Austria have contracted COVID-19. While many

of these patients have recovered fully, a signiﬁcant

portion suffers from COVID-19 symptoms long af-

ter they were declared as cured. As of November

2021, over 1 million people in Austria have con-

tracted COVID-19, while over 12 000 people have

died from the disease. Globally, there are 258 mil-

lion recorded cases of COVID-19, and over 5 million

deaths (Dong, Ensheng and Du, Hongru and Gardner,

Lauren, 2020).

The persistence of COVID-19 symptoms after

the patients have recovered from COVID-19 is com-

monly referred to as Long COVID. These symptoms

include (among others) fatigue, shortness of breath,

chest pain, memory and concentration problems, and

dizziness (Venkatesan, Priya, 2021). Determining

https://orcid.org/0000-0002-4808-742X

https://orcid.org/0000-0002-0088-9140

the incidence of Long COVID is difﬁcult, since cur-

rently there exists no single deﬁnition with interna-

tional recognition. Despite this, some studies assume

that around 10% of COVID-19 patients develop Long

COVID symptoms after recovering from COVID-19

(Mahase, Elisabeth, 2020).

Independent of how the COVID-19 pandemic pro-

gresses internationally, the problem of Long COVID

is getting more and more relevant and still has many

unknown factors. One drawback people with long

covid experience is often sharp declines in their qual-

ities of life, and their inability to perform daily tasks

reliably (Nabavi, Nikki, 2020).

Unrelated to COVID, a trend among healthcare

professionals and researchers has emerged to combine

all relevant data generated over a patient’s treatment

for a disease. This concept of mapping data onto a Pa-

tient Journey, and therefore combining various inputs

and data points from multiple healthcare providers

and patients has become increasingly important over

the last years (Georghiou, 2021). The Patient Jour-

ney model has primarily been used within health-

care facilities to provide their patients with infor-

mation and prevent the impact of conﬂicting or out-

dated information. For instance, services to improve

the Patient Journey are used with peri-operative pa-

tients (Willems, Stijn J and Coppieters, Michel W and

Pronk, Yvette and Diks, Miranda JF and van der Hei-

Hausberger, A., Tappeiner, B., Baranyi, R. and Grechenig, T.

Long COVID Diary: A User Centered Approach for the Design of a Mobile Application Supporting Long COVID Patients.

DOI: 10.5220/0010972300003123

In Proceedings of the 15th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2022) - Volume 5: HEALTHINF, pages 769-776

ISBN: 978-989-758-552-4; ISSN: 2184-4305

769

jden, Klaas WAP and Rooker, Servan and Scholten-

Peeters, Gwendolyne GM, 2021) or with stroke pa-

tients (Davoody, Nadia and Koch, Sabine and Krakau,

Ingvar and H

agglund, Maria, 2016).

Patient Journey apps are applications that provide

their users with information about their illness and

their treatment. These apps may allow users to track

their health progress and keep in touch with health-

care providers. In general, Patient Journey apps are

designed for calls to action at relevant points of time

and accompany them on their “health journey”, be-

sides being a central information point regarding their

situation. Ideally, a Patient Journey app’s ﬁrst goal is

to support patients at all times, not just when inter-

facing with medical professionals (Timmers, Thomas

and Janssen, Loes and Kool, Rudolf B and Kremer,

Jan AM, 2020).

The emergence of personal computer devices with

health data recording capabilities (e.g., smartwatches,

phones, ﬁtness tracking wristbands) has opened new

ways of generating, interpreting, and collecting health

data. Major phone companies, such as Apple (Apple,

2021), Google (Google, 2021), and Samsung (Sam-

sung, 2021), provide ﬁrst-party applications, which

aim to be a central and secure storage for all kinds

of personal health data. Modern Patient Journey ap-

plications are expected to integrate with the patients’

phones, and as a result, can use a plethora of useful

health data. The data that is recorded using users’

phones may not be reliable enough to support medical

decisions (and few, if any, widely available health de-

vices are classiﬁed as medical devices), but the sheer

amount of acceptable health data recordings might

provide beneﬁts for the patients and their medical

supporters nonetheless (Klasnja, Predrag and Pratt,

Wanda, 2012).

Due to the relative uncertainty among researchers

and medical professionals, the risk of misdiagnosis

for patients with Long COVID is large. Since many

of the symptoms of Long COVID have a cognitive as-

pect (e.g., fatigue or diminished concentration), some

patients have been diagnosed with depression or other

psychological disorders (Nabavi, Nikki, 2020). In the

authors’ opinion, a Long COVID app should ideally

help patients record their daily symptoms, and there-

fore support them in managing their illnesses.

Additionally, a Long COVID app should be able

to record reliable data, which should be helpful to

doctors and other healthcare professionals.

From a more broad perspective, using the ubiquity

of smartphones to provide patients of Long COVID

with a support app seems patently worthwhile. In

addition to supporting patients by letting them track

their symptoms and receive useful information, such

an app could also aid medical treatment, e.g., by hav-

ing an option to share patient data.

As knowledge of the disease itself is still devel-

oping, and medical guidelines are currently being

published, the risk of misdiagnosis is ever-present

(Raveendran, 2021). One possible solution is en-

abling the patients to systematically record their daily

health and create a reliable basis of data. Using this

data, the quality of medical decisions may be im-

proved.

This paper covers a user centered approach for the

requirements analysis of a Long COVID Patient Jour-

ney App (the ”Long COVID Diary”) and the proposal

of expected features. As the amount of available re-

search for Long COVID is still comparatively small,

an exploratory approach to requirements analysis has

been taken, as this information is currently missing

from state-of-the-art research. To that end, a speciﬁc

questionnaire was created to gather information on

what a possible Long COVID support app should do.

The following sections are structured as follows:

Section 3 contains related work, section 2 describes

the methodology that was used to gather feedback

from long COVID patients as well as their corre-

sponding requirements, which are outlined in section

4. This publication concludes with a discussion and

possible future work in section 5.

2 METHODOLOGY

Tho get to know the current state of long COVID pa-

tients and requirements for a supporting app a ques-

tionnaire was conducted in German using Google

Forms together with a public participation link. The

questionnaire was conducted among Long COVID

Austria, an Austrian self-help group for patients suf-

fering of Long COVID (Long COVID Austria, 2021).

An English version of the questionnaire can be pro-

vided by the authors on request.

The questionnaire is divided into four sections,

with the ﬁrst section being an introductory text to

inform the participants of the aim and setting. The

second section, Health Questionnaire (in German:

Gesundheits-Fragebogen) contains translated items

from the CHSS’ Living With Long COVID question-

naire (CHSS - Chest Heart & Stroke Scotland, 2021).

The third section contains questions and research

items about potential app features and the partici-

pant’s general technical ability. Finally, in the fourth

section, relevant demographic items are included.

The questionnaire was conducted over ﬁve weeks

via Google Forms. After the initial contact with a

group administrator, the link for participating in the

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770

study was shared among members of said group (e.g.,

in a private Facebook group). Until the end of the con-

duction period, no further contact was made with the

participants, nor was access to the Facebook group

granted to the researcher. The inﬂux of results was

monitored sporadically, and no systematic trends re-

garding the participation frequency were observed.

After getting back the results, they were analyzed and

discussed for preparing a possible future implemen-

tation of the app based on the needs of long COVID

patients.

3 STATE OF THE ART

In current state-of-the-art solutions, no similar appli-

cation covering Long COVID aspects was found. In

particular, no app publicly in development or avail-

able aims to offer health diary functionality to pa-

tients. Instead, most COVID-related apps that were

identiﬁed, put their focus on patients with COVID-19,

rather than patients with Long COVID.

Collado-Borrell et al. (Collado-Borrell et al.,

2020) identiﬁed 114 apps related to COVID-19. 62

(54,4%) were developed for Android, 52 (45,6%) for

iOS, and 50 (43,9%) for both operating systems. Most

of these apps were developed in Europe, followed by

Asia and North America. The most used languages

are English, Spanish and Chinese. Most of these apps

were developed in the name of governments or com-

panies related to the health sector. In addition to these

ﬁndings, Ramakrishnan et al., (Ramakrishnan et al.,

2020) also published similar ﬁndings.

Perhaps most prominently, a research app co-

created by researchers from the University of Leeds

is currently being used by 27 hospitals in the UK

(University of Leeds, 2021). This app uses the York-

shire Rehabilitation Scale to track individual health

progressions (Sivan et al., 2021).

When looking at the broader ﬁeld of health-

care, several state-of-the-art projects that aim to offer

health diary functionality become apparent. For men-

tal health diary apps, several key traits for success-

ful app development were identiﬁed by Goodwin et

al. (Goodwin et al., 2016). The researchers identiﬁed

readily available information, easily usable diary fea-

tures, and graphic representation of results as the most

requested features among their sample. In a study by

Yoo and Suh (Yoo and Suh, 2021), a self-care health

diary app for recipients of a heart transplant was de-

veloped, and tested among a small number of patients.

The patients who participated in this study responded

highly positive to the app, but reported the wish for

better usability. In a literature overview by Lee et al.

(Lee et al., 2018), a sizable number of mobile health-

care apps (including both medical and non-medical

applications) were compared. The researchers state

that while many of these apps could show success

within their study, few apps would then be further de-

veloped.

4 RESULTS

The questionnaire - given to a group of patients of

Long COVID (who would later be the main target

group for a Long COVID app) - should both pro-

vide insight into the needs of this patient group as

well as speciﬁc requirements for and identiﬁcation of

relevant app features. Furthermore, conducting this

exploratory survey among patients of Long COVID

should deliver valuable insights into whether a Long

COVID-related app is desired by its most likely target

group and could support their recovery.

The questionnaire contains both a medical as well

as an app-related section. The medical section pro-

vides insight into how patients with Long COVID

deal with the illness and its symptoms on a day-to-

day basis. The app-related section is used to gauge

interest in suggested features, as well as for allowing

participants to suggest app features themselves. Ad-

ditionally, this section should give a broad overview

of the technical abilities of the target group.

The questionnaire was written and conducted in

German, and constructed using Google Forms. It is

comprised of four sections:

1. Health: General questions about the participants’

health and impact of Long COVID on their daily

lives.

2. Feature Suggestion: Items about which features

a Long COVID support app should implement in

order to be useful.

3. Technical Skill: Items that aim to assess the tech-

nical ability and willingness to regularly use a

smartphone app.

4. Demographics: Items about age and gender of

participants.

The questionnaire mainly uses choice items, with

an option to add a freeform answer wherever sensible.

Before starting, the participants were briefed about

the goals and length of the questionnaire. The link

was shared among participants in their (private) Face-

book group.

Overall, 193 participants took part of the study.

Rudimentary statistical checks did not indicate any

reason to exclude a participant. Therefore, the ques-

tionnaire was concluded with an n=193 participants

Long COVID Diary: A User Centered Approach for the Design of a Mobile Application Supporting Long COVID Patients

771

sample. As mentioned earlier, the questionnaire was

conducted solely with members of Long COVID Aus-

tria. The sample is majority female, with 86% of

participants identifying as women. The majority of

participants are between 25 and 55 years old, with

80% stating their age within this range. While more

women than men are assumed to suffer from Long

COVID (Daniel Ayoubkhani , 2021), the sample

likely skews more female than the general population

of patients with Long COVID. The sample also likely

skews younger than the general population since Long

COVID Austria is primarily organized online.

4.1 Symptoms of Long COVID

In the sample, approximately 77% of participants

have been suffering from Long COVID for longer

than four months, with another 19% suffering for two

to four months.

The most common symptoms experienced are (in

decreasing order of frequency): Fatigue, lack of focus

or brain fog, tachycardia, headaches, and difﬁculties

breathing. Other symptoms include loss of sense of

smell or taste and various physiological and psycho-

logical symptoms.

Close to 90% of participants reported fatigue, and

79% of participants reported lack of focus as a symp-

tom. These two symptoms are by far the most com-

mon among the sample. Notably, around 11% of par-

ticipants reported a loss of sense of taste, which is a

salient symptom of COVID-19.

Self-reported symptoms were manifold and in-

cluded reports of debilitating weakness, insomnia,

and gastrointestinal distress. These symptoms were

clustered into either “physiological” or “psychologi-

cal” to allow better representation. For more informa-

tion, see Figure 1.

Most participants report daily ﬂuctuation in their

perception of symptoms, with 64% stating that their

symptoms varied “day to day”.

The impact of COVID-19 and Long COVID on

the perceived health of the participants is signiﬁcant:

97% of the participates indicated that they believe, be-

fore getting sick with COVID-19, the state of their

health seemed as either Very Good or Good. After

the disease, and while dealing with Long COVID, al-

most as many (93%) report that their health has de-

clined. More notably, every participant noted a de-

terioration in their health (by reporting a better state

for Item 4 than for Item 5). See Figure 2 for more

information and the appendix for the exact phrasing

used for both items. Well above 80% of participants

report that the disease has impacted their social life,

work life, and mental health negatively. More than

Figure 1: Reported Symptoms (Multiple Choice + Freeform

Entry).

Figure 2: Reported State of Health Before (left) and After

COVID-19 (right).

60% state that their relationships have been affected

by Long COVID. For more information, see Figure 4.

4.2 App Features & Technical Ability

Overall, the sample has shown a high level of self-

reported tech literacy. Over 80% of participants state

that they mostly or fully agree with the statement “I

am competent with technology, and am knowledge-

able regarding my phone”. Over 85% of participants

report that they use between two and ten different mo-

bile applications every day. Participants were asked

which potential features they would deem “impor-

tant” for a Long COVID support app. An up-to-

date overview of support offers for patients with Long

COVID was chosen by about 87% of participants. En-

tering data of various symptoms associated with Long

COVID was chosen the second-most often: Entry of

fatigue was the most common among this subset, with

80% of participants choosing this answer. The follow-

ing symptoms were chosen less often: Daily health at

75%, breathing performance at 52%, and blood oxy-

genation at 50%. The feature of an overview of ap-

pointments and events was also chosen quite often

(66% for user-deﬁned appointments and 55% for ex-

ternal events). For more information, see Fig. 3.

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Figure 3: Potential features that were deemed important.

Figure 4: Reported Impact of Long COVID in Different

Areas of Life.

4.3 Requirements

Due to its sample size and straightforwardness, the

questionnaire results provide a rich basis for informed

decision-making in regard to application prototype

design. All participants’ reported deterioration of

personal health is a strong signal to the public to

take health care for patients with Long COVID se-

riously. Furthermore, it signals the need for an app

to accompany patients when dealing with the illness.

Also, since the majority of participants report that

their symptoms vary over time, keeping track of these

symptoms is likely to be important as well. The par-

ticipants all report a high level of interest in a pro-

posed Long COVID mobile application. It stands to

reason that the self-reported level of interest is not

directly applicable to the expected usage of the app.

However, a general level of interest further indicates

the need for such an app.

All in all, the ﬁndings justify the further planning

and development of a Long COVID Support app, the

”Long Covid Diary”. When looking at the results of

the questionnaire, some general insights for the devel-

opment of the app prototype can be gained:

• Many participants have a high demand for an app

that lets them track their symptoms.

• The participants in the sample state their motiva-

tion for regular use

• Due to the prevalence of neurological and psy-

chosomatic symptoms (e.g., fatigue, lack of focus,

etc.), the app has to rely on the users self-reporting

their daily state. In the authors’ opinions, there is

no easily measurable metric available.

Based on these results, a set of app features and re-

quirements have been compiled, which are described

in more detail within the following table (see 1). The

table provides the feature ID (abbreviated with FE),

the feature name, its description, as well as a link to

the results of the questionnaire and their justiﬁcations

to include it in the list.

Features FE02, FE03, and FE04 were mentioned

overwhelmingly often in the questionnaire items

about app features, whereas in FE01, the entry of

blood oxygen values was chosen less frequently than

the other features (about 50%). However, several

health organizations recommend the continued mon-

itoring of blood oxygen levels using pulse oxime-

ters (e.g., (Healthwise Staff, 2020)). More recently,

the use of pulse oximeters by patients without medi-

cal supervision has been criticized (Greenhalgh et al.,

2021). Despite this, the feature should be included

in a prototype in the authors’ opinion to enhance the

self-monitored symptoms with data collection from

sensors.

Feature FE02, the input of data to track symptoms

regularly, was mentioned by around 80% of partic-

ipants. Since many of the symptoms experienced

by people with Long COVID are neurological and

psychological, direct measurement is often hard or

impossible. Therefore, the app should rely on self-

report-style questionnaires. Ideally, these question-

naires should be clinically tested, usable and easy to

ﬁll in a short period.

Feature FE03, an overview of COVID-related ap-

pointments, has no direct impact on health data

recording. However, its inclusion is warranted, as the

feature’s usefulness may increase the frequency and

duration of app usage and, therefore, increase the mo-

tivation for recording health data.

Similarly, Feature FE04, which was mentioned the

most often in the questionnaire (at about 87%), has no

direct impact on health data recording but of course

on the support of patients of this new disease. Also,

being presented with up-to-date news may again in-

crease the frequency of app usage. Feature FE05, a

dashboard, is included not for its own sake but as a

tool to convey information to the user quickly. A mix

of information and prompts to participate are included

in the dashboard, which should be the ﬁrst view pre-

sented to the user. Daily questionnaires, such as a

daily fatigue questionnaire, could be shown promi-

nently on the dashboard. Also, statistics about symp-

Long COVID Diary: A User Centered Approach for the Design of a Mobile Application Supporting Long COVID Patients

773

Table 1: Requirements.

ID Feature Name Description Link to questionnaire

FE01 Reading and entering

blood oxygen values

This will allow users the entry of blood

oxygen values. Blood oxygenation is

used as a measure of pulmonary health

and is recommended by several health

organizations.

The feature was mentioned by about

50% of participants in the question-

naire. Blood oxygenation is assumed

to be a valuable metric of pulmonary

health.

FE02 Reading and enter-

ing questionnaires

about Long COVID

symptoms

This will allow the entry of various

health symptoms using short question-

naires. The questionnaires will be partly

based on clinical questionnaires and in-

clude freeform items to track diverse

symptoms.

The feature was mentioned by about

80% of participants in the question-

naire.

FE03 Reading and entering

appointments related

to Long COVID

The app will allow the entry and display

of Long COVID-related appointments

and activities. Integration with the sys-

tem calendar is also possible. Users

may enter appointments using an in-app

form and save these appointments in

their phones’ calendars.

The feature was mentioned by about

70% of participants in the question-

naire.

FE04 Presentation of cur-

rent news related to

Long COVID

This feature will include an overview of

recent news gathered by various sources.

The app will preview a portion of the

news items. After that, a web link to the

news source will be given.

The feature was mentioned by almost

90% of participants in the question-

naire.

FE05 A dashboard -type

feature to serve as a

general overview

The dashboard will be the main view on

opening the app by default. Here, an

overview of current status and activities

will be displayed.

While not mentioned explicitly in the

questionnaire results, an overview of

current activities is a good app design

practice based on the authors’ opin-

ions.

FE06 Food intake tracking Tracking eaten meals throughout a more

extended period appears to be an obvi-

ous feature for a Long COVID support

app. The addition of a simple food in-

take tracking feature allows for a multi-

faceted view of the users’ health.

Food tracking functionality was men-

tioned sporadically as a free-form an-

swer.

FE07 Entry of other biomet-

ric data: Pulse, blood

pressure, etc.

Similarly to FE06, the addition of other

health-related data (some of which are

readily available using ﬁtness tracking

devices, e.g., a smartwatch with an in-

tegrated pulse meter) may allow for

a more broad picture of users’ daily

health.

The tracking of biometric data, as

well as general ﬁtness and movement

data was suggested in the free-form

answer ﬁelds of the questionnaire.

FE08 Entry of physiologic

and psychological

symptoms

The entry of various symptoms, such

as headaches, shortness of breath, panic

episodes, mainly using quick question-

naires may beneﬁt the understanding of

disease progression for both the users

and potentially researchers.

Several symptom tracking features

were suggested in the free-form an-

swer ﬁelds of the questionnaire.

FE09 Contact data of doc-

tors and medical pro-

fessionals

As a Long COVID support app be-

comes important in users’ lives, a way to

quickly call or message their healthcare

providers appears to be a good ﬁt for the

app.

The ability to contact healthcare

providers was mentioned in the con-

text of FE04. Patients expect to be

able to contact their doctors and/or

caretakers.

FE10 Share data The ability to share data is an important

feature to connect the data collected by

patients with medical workers.

The ability to share data, both with

healthcare professionals as well as

other people was suggested by the

majority of participants.

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tom data from the recent past should help users to gain

awareness and oversight about their symptoms. Fea-

tures FE06-FE10 were mentioned somewhat less but

were added after internal discussion and comparison

with other apps to round off the feature set.

To the authors’ opinions, the features described

here are important, because they allow the tracking

and displaying of health data. Since most participants

stated that they would be willing to share the data

gathered by a Long COVID support app in some

form, the secure storage and export of said data ap-

pear to be equally important. Therefore, the inclusion

of a feature set to export the data in a generally

readable data format (e.g., PDF or CSV) is pursued.

For an overview of the the identiﬁed features, see

Table 1. The feature-list refers to the results of the

questionnaire, which were clustered and condensed.

5 CONCLUSION AND OUTLOOK

The conduction and analysis of the questionnaire has

provided useful information and insight into a group

of patients whose impact on the health system will

only increase in the coming months. At the time

of writing, no clear outlook for patients with Long

COVID is available. Diagnoses and treatment options

are likely to shift and be subject to discussion.

In this context, the development of a mobile appli-

cation that accurately collects health data is strongly

recommended. The app should be reliable in its data

collection to provide information not only for the pa-

tients but also for medical professionals. Further-

more, a Long COVID app could become a valuable

tool for people monitoring their symptoms. As men-

tioned in previous sections, diagnosing Long COVID

is still difﬁcult, and misdiagnoses are a burden for pa-

tients and a problem for healthcare systems. Giving

patients the ability to track their symptoms regularly

might make a difference in improving diagnostic ac-

curacy and, therefore, treating Long COVID.

When looking at the features that were deemed

important, it becomes clear, that a successful Long

COVID support app should do more than simply track

users’ symptoms and daily health status. Participants

who participated in the presented questionnaire ap-

pear to request features that provide up-to-date infor-

mation, appointments, and activities. Supporting peo-

ple with Long COVID means more than simply moni-

toring their health but also assisting them in their daily

lives in various ways.

The inclusion and participation of users from

the ﬁrst step in the design and development process

is necessary to support the above mentioned goals.

Apart from strictly feature-based deliberations, im-

plementing an app prototype should also focus on

straightforward, modern design and ease of use prin-

ciples. Ideally, a Long COVID support app should

conform to the platform’s UI guidelines whenever

possible. The user centered approach in all develop-

ment stages increases the usability and, again, may

increase the frequency of use of the app.

While providing valuable insight regarding the de-

sign of an app prototype, the questionnaire and its

result are limited by its methodology. One obvi-

ous criticism is the selection of the sample and the

lack of control of participant access. All participants

were members of the Long COVID Austria Facebook

group. Based on this, the base level of personal inter-

est in dealing with Long COVID can be assumed to be

higher than in the general population (of people deal-

ing with Long COVID). This might impact the results

of the technical portion of the questionnaire, in which

features and expected app usage were stated. But pre-

cisely because of the app being speciﬁcally designed

for Long COVID patients, this user group is the main

target of future users.

After initial design, a prototype should be handed

out to get further feedback on the implementation of

the proposed requirements for a Long COVID appli-

cation.

In terms of future work apart from the implemen-

tation a larger scale evaluation should be conducted

afterwards. Within that setting also gamiﬁcation (mo-

tivational) aspects could be covered as well, to see if

those elements support the motivation and use of the

application by long COVID patients.

The questionnaire and results presented in this pa-

per are the ﬁrst important step towards developing a

Long COVID support app, tentatively named Long

COVID Diary. The authors think, based on the given

results, that such an application is absolutely neces-

sary and should be developed based on the here pre-

sented ﬁndings. The here presented research provides

valuable insight into the requirements of patients with

Long COVID and are considered a good starting point

for further research and development. Design ap-

proaches will be discussed to provide and test the pro-

posed feature-set with the user group following the

user-centered design approach.

ACKNOWLEDGEMENTS

The authors would like to thank all participants

answering the provided questionnaire. Without their

Long COVID Diary: A User Centered Approach for the Design of a Mobile Application Supporting Long COVID Patients

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help and input, this research would not have

been possible.

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