My 30-day (Apple Watch) heart-rate history, shows so much variation—maybe ±2bpm/day—in my day-to-day resting pulse that the increased rate that looks incredible as a composite would be nearly useless for an individual
Assuming others experience this level of variation
I looked especially at May 30 bc i got the COVID update I’d been deferring until the Fall upswing. No change in my 48bpm resting pulse for it ‘ 2 days after
I have a long-term trend from ~60+ bpm to ~50 that MAY reflect my diet/exercise kick this year, accompanied by a 32lb weight loss w MORE energy/activity/jog-speed. Or not🤷🏻♂️
Of all the watch measurements and guesses (VO₂Max?!? Sleeping respiration rate? O₂ saturation), I presume resting heart rate is the LEAST prone to estimation or measurement errors
76yo now-only-somewhat-BMI-overweight male; feel free to use my info (w/o name) for any purpose and thanks for Inside Medicine
I chose the heart rate outcome to share because it is easiest to explain. But in the paper, they looked at other issues like variability and also daily steps. On the individual level, the best data (I am told from insiders) happens DURING SLEEP. Makes sense.
First: I *had* to fly recently, for the first time since 2019, at which time I was flying pretty much constantly. But my daughter was getting married, she's on the other side of the country, so... had to go. I wore an N95, which was A Good Thing because the plane sounded like a Covid (or tuberculosis) ward. But what I'd also done in the week before I flew was, uh, self-enrole in Akiko Iwasaki's experiments with the use of nasally applied Neosporin to (her very early trials show) trigger Toll-like receptor 3 in cells known as conventional dendritic cell type 1. The Toll-like receptor 3 on the host cell induces interferon and interferon stimulated genes to prevent the replication of the virus -- in fact any virus.
Did it work? Well I had to attend numerous social engagements maskless (can't walk her up the aisle with an N95, right?), flew back on a similarly consumptive plane, isolated for five days, and didn't get the plague. You can read/listen more about Akiko's experiments here: https://erictopol.substack.com/p/akiko-iwasaki-the-immunology-of-covid.
Second: beware the Apple Watch when it comes to cardiac analytics. While it *can* be accurate, a lot depends on how tight it is worn, and how consistently that tightness is applied each day. Folks using adjustable straps are not going to get consistent readings; elastic straps are better. Also, there are a whole bunch of papers out there questioning the accuracy of the data the watch supplies (and, in fairness, others that find precisely the opposite). What I do know is I recently triggered its "fall detector" while stirring a cup of coffee... :)
Thank you for sharing all of this. Very interesting.
As above, the researchers look at a lot of things to make sure they can determine signal and noise. (Like...if you exercise for an hour, that would mess things up. I think they've sorted that all out). It turns out that data during sleep is most useful.
As a fellow mask wearer in certain circumstances, I'm curious if your masking habits will change following this infection?
I haven't had COVID and wonder if I did have it, would that change how I feel about it? I quite enjoy just not getting sick in general. I'm the only one in my medical office that still masks with patients, which blows my mind a little bit.
Hi Angela! My mask wearing will not change due to this, I don't think. When I'm at work, I treat a high risk group of patients, and flu and RSV (and other coronaviruses) can be just as bad as Covid. Generally, in other situations I am intermittent in my mask use, depending on the environment (as you allude to). Over time I have chosen to take more risks (i.e., indoor dining) but I don't think having Covid will particularly accelerate any long term changes in my habits.
I also don't get why people in healthcare settings do not mask.
I had Covid for the first time in August 2023. I just reviewed resting heart rate data from my Apple Watch. The day I became symptomatic my resting HR went up to 80 from 71.
I had a nasty chest cold over Christmas and tested negative for Covid on multiple occasions. Christmas Day was when I felt really bad. Again, resting HR was 80 on Christmas Day.
I’ll be paying closer attention to this over time.
I have a smart watch but I have to check my vitals and I didn’t notice my heart rate up until I had Covid this last time. It baffles me that no one else got it as I got sick in the middle of the night and my husband moved to a different room as soon as I tested positive that morning! My only place I can think I got it was from a sick colleague who did not test. It’s getting harder to know when to mask back up(always do in airport) in stores or restaurants.
I recall reading that changes in resting heart right might be an early signal of an infection (don’t recall where now, perhaps a post by Eric Topol?). So I started watching my overnight resting heart rate as determined by my Apple watch. It’s usually around 59 bpm, ranging from 58 to 60 bpm. I’ve noticed that it usually goes up to 63 bpm or so after a vaccination (for example, after Covid boosters). The only time I had covid (July 2022, and I understand it is possible that I have had asymptomatic Covid without knowing it), it went up to 70 to 73 bpm while I tested positive on rapid antigen tests. I do not recall how quickly it went back down to 59 bpm. I took Paxlovid and tested negative starting on Day 8. My symptoms were mild — much more so than your recent symptoms.
I have seen my overnight resting rate go up to the 63-64 bpm level after traveling by air. I suppose that could be from exposure to some disease that my immune system has then managed to fight off. [Since the start of the pandemic, I generally wear an N95 or KN95 in airports and on airplanes and have had all the Covid shots I’m eligible for (currently I’m 66).] Or I suppose the change in overnight resting heart rate could also be from disruption to my circadian rhythms on longer flights.
Are their particular apps you have seen that are generally available and might offer more sophisticated analysis of heart rate changes?
Fascinating! If only it were an alternative reality movie and not the soup we Earthlings are walking around in! (Wouldn’t it be nice if anyone who wanted a stripped down watch version could have one, cheaply or for free? At least the apps are out there, hopefully being proven worthy.) If doable for folks, what a great tool in the tool belt!
There probably are cheapie options for this purpose. I am not versed in the market but even the Apple Watch is "only" a couple hundred bucks and it looks like some Fitbits cost less. My issue is that I hate wearing watches!
Maybe it’d be helpful to share my data
My 30-day (Apple Watch) heart-rate history, shows so much variation—maybe ±2bpm/day—in my day-to-day resting pulse that the increased rate that looks incredible as a composite would be nearly useless for an individual
Assuming others experience this level of variation
I looked especially at May 30 bc i got the COVID update I’d been deferring until the Fall upswing. No change in my 48bpm resting pulse for it ‘ 2 days after
I have a long-term trend from ~60+ bpm to ~50 that MAY reflect my diet/exercise kick this year, accompanied by a 32lb weight loss w MORE energy/activity/jog-speed. Or not🤷🏻♂️
Of all the watch measurements and guesses (VO₂Max?!? Sleeping respiration rate? O₂ saturation), I presume resting heart rate is the LEAST prone to estimation or measurement errors
76yo now-only-somewhat-BMI-overweight male; feel free to use my info (w/o name) for any purpose and thanks for Inside Medicine
Hi Walt--
I chose the heart rate outcome to share because it is easiest to explain. But in the paper, they looked at other issues like variability and also daily steps. On the individual level, the best data (I am told from insiders) happens DURING SLEEP. Makes sense.
Thank you for sharing this information!
Hey Jeremy, a couple of thoughts:
First: I *had* to fly recently, for the first time since 2019, at which time I was flying pretty much constantly. But my daughter was getting married, she's on the other side of the country, so... had to go. I wore an N95, which was A Good Thing because the plane sounded like a Covid (or tuberculosis) ward. But what I'd also done in the week before I flew was, uh, self-enrole in Akiko Iwasaki's experiments with the use of nasally applied Neosporin to (her very early trials show) trigger Toll-like receptor 3 in cells known as conventional dendritic cell type 1. The Toll-like receptor 3 on the host cell induces interferon and interferon stimulated genes to prevent the replication of the virus -- in fact any virus.
Did it work? Well I had to attend numerous social engagements maskless (can't walk her up the aisle with an N95, right?), flew back on a similarly consumptive plane, isolated for five days, and didn't get the plague. You can read/listen more about Akiko's experiments here: https://erictopol.substack.com/p/akiko-iwasaki-the-immunology-of-covid.
Second: beware the Apple Watch when it comes to cardiac analytics. While it *can* be accurate, a lot depends on how tight it is worn, and how consistently that tightness is applied each day. Folks using adjustable straps are not going to get consistent readings; elastic straps are better. Also, there are a whole bunch of papers out there questioning the accuracy of the data the watch supplies (and, in fairness, others that find precisely the opposite). What I do know is I recently triggered its "fall detector" while stirring a cup of coffee... :)
Thank you for sharing all of this. Very interesting.
As above, the researchers look at a lot of things to make sure they can determine signal and noise. (Like...if you exercise for an hour, that would mess things up. I think they've sorted that all out). It turns out that data during sleep is most useful.
Nice analysis!
Thanks John :)
As a fellow mask wearer in certain circumstances, I'm curious if your masking habits will change following this infection?
I haven't had COVID and wonder if I did have it, would that change how I feel about it? I quite enjoy just not getting sick in general. I'm the only one in my medical office that still masks with patients, which blows my mind a little bit.
Hi Angela! My mask wearing will not change due to this, I don't think. When I'm at work, I treat a high risk group of patients, and flu and RSV (and other coronaviruses) can be just as bad as Covid. Generally, in other situations I am intermittent in my mask use, depending on the environment (as you allude to). Over time I have chosen to take more risks (i.e., indoor dining) but I don't think having Covid will particularly accelerate any long term changes in my habits.
I also don't get why people in healthcare settings do not mask.
Same. How can individuals in healthcare not mask!?! Scary!
I had Covid for the first time in August 2023. I just reviewed resting heart rate data from my Apple Watch. The day I became symptomatic my resting HR went up to 80 from 71.
I had a nasty chest cold over Christmas and tested negative for Covid on multiple occasions. Christmas Day was when I felt really bad. Again, resting HR was 80 on Christmas Day.
I’ll be paying closer attention to this over time.
That’s amazing information. Thank you for sharing!
I have a smart watch but I have to check my vitals and I didn’t notice my heart rate up until I had Covid this last time. It baffles me that no one else got it as I got sick in the middle of the night and my husband moved to a different room as soon as I tested positive that morning! My only place I can think I got it was from a sick colleague who did not test. It’s getting harder to know when to mask back up(always do in airport) in stores or restaurants.
Thanks as always for an interesting article.
I recall reading that changes in resting heart right might be an early signal of an infection (don’t recall where now, perhaps a post by Eric Topol?). So I started watching my overnight resting heart rate as determined by my Apple watch. It’s usually around 59 bpm, ranging from 58 to 60 bpm. I’ve noticed that it usually goes up to 63 bpm or so after a vaccination (for example, after Covid boosters). The only time I had covid (July 2022, and I understand it is possible that I have had asymptomatic Covid without knowing it), it went up to 70 to 73 bpm while I tested positive on rapid antigen tests. I do not recall how quickly it went back down to 59 bpm. I took Paxlovid and tested negative starting on Day 8. My symptoms were mild — much more so than your recent symptoms.
I have seen my overnight resting rate go up to the 63-64 bpm level after traveling by air. I suppose that could be from exposure to some disease that my immune system has then managed to fight off. [Since the start of the pandemic, I generally wear an N95 or KN95 in airports and on airplanes and have had all the Covid shots I’m eligible for (currently I’m 66).] Or I suppose the change in overnight resting heart rate could also be from disruption to my circadian rhythms on longer flights.
Are their particular apps you have seen that are generally available and might offer more sophisticated analysis of heart rate changes?
Wow!
Fascinating! If only it were an alternative reality movie and not the soup we Earthlings are walking around in! (Wouldn’t it be nice if anyone who wanted a stripped down watch version could have one, cheaply or for free? At least the apps are out there, hopefully being proven worthy.) If doable for folks, what a great tool in the tool belt!
There probably are cheapie options for this purpose. I am not versed in the market but even the Apple Watch is "only" a couple hundred bucks and it looks like some Fitbits cost less. My issue is that I hate wearing watches!
I luuuuuuv wearing watches, but I wash my hands all day long, so it’s a no-go for me too!