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Aravind Natarajan, Hao-Wei Su, Conor Heneghan | Frontiers in Physiology | (2022)
Primary Link Pubmed DOI Openalex Full text (OA)

Abstract

The COVID-19 disease caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has become one of the worst global pandemics of the century. Wearable devices are well suited for continuously measuring heart rate. Here we show that the Resting Heart Rate is modified for several weeks following a COVID-19 infection. The Resting Heart Rate shows 3 phases: 1) elevated during symptom onset, with average peak increases relative to the baseline of 1.8% (3.4%) for females (males), 2) decrease thereafter, reaching a minimum on average ≈13 days after symptom onset, and 3) subsequent increase, reaching a second peak on average ≈28 days from symptom onset, before falling back to the baseline ≈112 days from symptom onset. All estimates vary with disease severity.

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Sample Definition And Size

The study analyzed resting heart rate data from individuals diagnosed with COVID-19, utilizing wearable devices to monitor heart rate over several weeks. The exact sample size is not specified in the provided information.

Study Type

Observational study using wearable devices to monitor resting heart rate in individuals diagnosed with COVID-19 over several weeks.

Conflicts Of Interest

No conflicts of interest were declared by the authors.

Results Summary

The study found that resting heart rate in individuals with COVID-19 exhibited three phases: 1) an initial increase during symptom onset, with average peak increases of 1.8% for females and 3.4% for males; 2) a decrease reaching a minimum approximately 13 days after symptom onset; and 3) a subsequent increase reaching a second peak approximately 28 days from symptom onset, before returning to baseline around 112 days from symptom onset. These changes varied with disease severity.

Referenced In

William Fan
9 months ago
William Fan's 2025 91 Day Weight Loss Challenge

Week 8: Resting and resting heart rate

  • Weight (7d avg): 186.9lbs/84.8kg, from peak -12.8lbs/-5.8kg

  • RHR (7d avg): 59.4bpm

  • Calories In (7d avg): 1686kcal

  • Exercise (7d avg): 500kcal

  • Net Deficit (total): -2300kcal

  • 2x5x500m row: 1:51.0, 1:49.6

Notes:

I saw a continued steady decline in my weight 2 weeks after my sleep apnea surgery. Recovery was slow but continual. Though I had hoped to be mostly recovered 2 weeks in, I was just starting to be able to eat normally again throughout the week. My decreased diet meant exercising was difficult. But as soon as I was able to increase my calories I was able get back to my gym routine.

One additional goal I had for this weight loss challenge was getting my resting heart rate down closer to where I was a few years prior, in the low 50s. As I entered my mid thirties, my RHR seemed to go up 1 bpm every year. It's difficult to say what caused this but I was very interested in seeing what I could do to get it back down.

Anecdotally, the more weight I lost and more exercise I got, the better my RHR. However, getting sick or recovering from surgery caused my RHR to rise within a few days. There's 3 categories I'm interested in when considering RHR impacts: weight loss, exercise, and illness.

Weight Loss

A meta-analysis from 2019 found an associated -9bpm with large median weight loss of 43kg. This ranged from 20% to 30% weight loss. In a 1 year controlled trial , RHR decreased by 4bpm with a 5-10% decrease in weight. There are several other confounding factors including diet and exercise that could also impact RHR, but generally weight loss seems to have a consistent effect.

Exercise

Easily the most well studied factor for improving RHR, a large systematic review and meta-analysis published in 2018 showed -5.2bpm from all types of sports, -6.0bpm from endurance training, and -2.5bpm from strength training. Notably, studies showed -7.2bpm from yoga specifically. These adaptations took several weeks to see drops, but I see impacts from my Fitbit within a few days of high aerobic activity.

Illness

I always see a spike in my RHR when I get sick and it can be quite discouraging. I try to keep my spirits up by reminding myself its temporary. A national US study looking at the relationship between body temperature and heart rate found a HR increase of 7bpm for every increase in T of 1.0°C or 1 .8°F. Diseases like COVID-19 saw increases of 1.8% for females and 3.4% for males on initial onset.

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