Health and Fitness Trackers Can Indicate COVID-19 Infection and Effective Treatment Modalities

by Dr. Susan Tanner, MD

With everyone sheltering in place and staying at home to avoid COVID-19 exposure, we are all doing what we can to stay mindful of getting in daily movement and adequate exercise as part of keeping our bodies healthy and our minds sound. Many of us may even be using a heart rate monitor or fitness tracker to keep up with daily steps, activity, exercise and/or fitness goals. But, did you know that you may also use these same tracking devices to help detect if you are becoming ill? Additionally, these devices may also be used to monitor how treatment and/or recovery is faring should you become ill or fall sick with the virus. I think with our COVID-19 pandemic, early infection diagnosis is especially important in order to prevent the spread of illness.

There are many health tracking devices on the market, the most popular of which is probably the Fit Bit, but my personal favorite is the Oura Ring. It is a wearable ring that connects to an app on your smart phone to allow you to track everything from movement to sleep quality and many things in between. Regardless of device preference, newer watches and similar devices can also provide helpful information far beyond what it advertised. For example, when you are becoming ill, your immune system has several strategies it can deploy to help you heal. These actions require a lot of energy and usually show up as signs of strain in your body that become evident through your body temperature, heart activity, respiration, and sleep or activity patterns.

If You Are Concerned and Worry You Are Getting Sick

Here are things you can keep an eye out for through your tracker that indicate signs of strain or impending illness:

(Note: Remember, it is important to compare all numbers to your normal baseline. Doing this will allow you to see deviations and abnormalities a lot better.)


  1. Increase in Body Temperature

As part of your immune system powering up to fight infection, your body usually raises an inflammatory response. Inflammation does exactly what it sounds like—“flame”—or heat up your body. Severe infections can even turn up the heat enough that your body generates a fever.  Many of my patients run a sub normal temperature; so, it is important to track the differences in basal temperature—or the measurement of your body temperature at rest. Many monitors allow you to look at a record of how your temperature has been running for a few weeks such that changes or jumps in temperature are obvious.

An individual’s body temperature typically changes by about 1° C (1.8° F) between its highest and lowest points each day. Anything outside of that range signals that something is challenging your body and preventing it from maintaining your ideal temperature range. Keep in mind that internal changes (e.g., a fever) or external changes (e.g., a warm bedroom) can cause temperature changes as well.

2.      Increase in Respiratory Rate

If a respiratory infection or cough is challenging your system, you may see an elevated respiratory rate. A typical respiratory rate for healthy adults is 12–20 breaths per minute. Keep in mind that hormone cycles can also impact your respiration, and illness may cause your rate to remain relatively high for some time after the actual symptoms have disappeared— letting you know your body is still recovering. Obviously, exercise will also increase respiratory rate, but the important thing to note is how quickly this rate returns to your normal baseline. Also, because of the elevated levels of pollen this time of year, those individuals with allergies may be having an increase in respiratory rate related to allergic sinus symptoms. If you suspect your symptoms are pollen-related, but traditional allergy treatments do not seem to be making a difference in maintaining normal respiratory rate, then it is time to be more vigilant about other inflammagens that may be causing the increase.

  1. Increase in Resting Heart Rate or Decrease in Heart Rate Variability

As your body fights an illness, it engages your sympathetic “fight or flight” response. This activity increases your resting heart rate and decreases your heart rate variability. Heart rate variability (HRV) is a great monitor of cardiac fitness and is described as the interval between heart beats. When this variability can be monitored properly, then it can become a sensitive measure for change to indicate impending illness.

Another explanation of heart rate variability is this—a healthy heart is not meant to have a heart rate that stays the same throughout the day. Think about how your activity or emotions affect your heart. At times, your heart rate should speed up and at other times, it should slow down. When I person is ill, it is generally thought that this variability decreases. What is more important, though, and what these wearable devices can show you is how your HRV uniquely trends. In other words how your HRV looks when you are sleeping, exercising, eating, and feeling your best verses how it looks when you are stressed at work, not sleeping well, are getting sick, or are dehydrated. Knowing what your own patterns look like also helps you to more easily identify when sickness if coming on or when you need to make sure you get a bit more sleep or water throughout the day. In fact, HRV can be such a helpful tool, that athletes determine their daily training (hard workout vs. yoga or rest day) by their HRV, and many functional medicine doctors measure their patients’ HRV to determine if treatments are working or are counterproductive. Since HRV is so unique to each individual, it really helps to detect minor and sometimes overlooked changes in the body.

  1. Changes in Sleep or Activity

If your body is prioritizing rest, it’s natural to spend more time in bed. You may naturally engage in lower amounts of activity or notice that your body shows patterns of prioritizing deep sleep, which is the most physically restorative sleep stage. A good sleep monitor–which many wearable devices include– can show you how much time your body is spending in various phases of sleep and wakefulness.

Which Patterns Should I Look For?

While looking at your data, I find that it is helpful to tell my patients to start by asking themselves a few questions:

  • When you start to feel sick, do you see an increase in your body temperature?
  • Do you notice other signs of stress in your body when your temperature changes (e.g., lower heart rate variability, higher heart rate, increased respiration rate)?
  • Are there recovery routines that help your body rebound and resume “normal” patterns, like getting more sleep, or drinking more water throughout the day?

If any of these changes are increasing and not resolving, even when you employ behaviors that usually get you back on track, then it may be time to contact your physician with your concerns. These are stressful times, and it is hoped by knowing that we have a few extra tools we can use to know our bodies, that we can minimize the way such stress impacts our health. The bonus is that these tracking tools will also help you to be proactive. Thus, if it is time to seek medical care, you can do so sooner, rather than later. Also, let’s not forget the value of the many preventative strategies focused especially on immune health and COVID-19 that we have written about in previous articles.

Best Practices for Preventing COVID-19 Infection

To quickly review, preventative strategies include the following:

  • Sheltering in place and avoiding crowds and public places as much as possible;
  • Washing hands frequently with soap and water for 20 seconds—don’t forget your thumbs! Use alcohol-based hand sanitizer if you can’t wash;
  • Not touching your face, eyes, mouth, or nose. This virus needs a human host to survive. Don’t allow it entry;
  • Wearing a mask when you do have to go out in public places. It is advisable at this time to use face coverings or fabric masks rather than nothing at all. Masks do seem to reduce the spread of this virus and have helped in flattening the curve in countries where all people wear masks when in public places;
  • Quieting your mind of worry through exercise (at home of course), meditation, and prayer;
  • Using nutritional support for the immune system (please see previous articles for complete list);
  • Seeking medical advice if evidence and symptoms point to illness;
  • Being careful and cautious without panic. Panic and stress can do a number on your immune system. Do all you can to stay and be healthy, and feel confident in your efforts.

Please know that you are not alone, we are all in this together. We may be socially distancing from each other, but we are still a community of people working together. So, while we are separate, none of us is alone. I look forward to us conquering this virus together.

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