Could Fitness Wearables Help Detect Early Signs of COVID-19?

Local company WHOOP is helping investigate how changes in respiratory rate may be an early indicator of the coronavirus.

Photo provided by WHOOP

We’ve been counting our steps and monitoring our heart rates using fitness wearables for quite some time. Some homegrown wearables like Nix and Embr Wave even monitor your hydration levels and body temperature. Now, with the ever increasing public health concern of COVID-19, Boston-based fitness wearables company WHOOP may have found a way to use its data to help detect the earliest sign of the virus: an increase in respiratory heart rate.

Emily Capodilupo, WHOOP Vice President of Data Science and Research, says the company came across the connection after a WHOOP member noticed his respiratory rate, or how many breaths you take in a minute, skyrocket from 14.5 to 18 in just one day. He later reported his findings to the company after being diagnosed with the disease. The changed respiratory rate was the first indicator that he wasn’t fully healthy.

“It takes a lot to disturb your respiratory rate,” Capodilupo tells me over the phone. It’s also important to note that respiratory rate is different from resting heart rate, which is different from heart rate variability. Respiratory rate is the number of breaths (inhales and exhales) you take in a minute and ranges from 12-20 breaths in a healthy person. Resting heart rate is the number of times your heart beats per minute and ranges between 60-90 in a healthy person, and heart rate variability is the time in between each heart beat. The latter two are more susceptible to fluctuations, while respiratory rate remains steadier. “Generally speaking, you want a low respiratory rate, a low resting heart rate, and a high heart rate variability,” she says.

For the WHOOP member who originally reported the changes in data, his respiratory rate usually only ever deviated between 14.5-15. A jump to 18 breaths per minute is a 17 percent increase from baseline and shows something much more significant is going on, Capodilupo explains. “COVID-19 is primarily a lower respiratory tract infection, so it was worth seeing if there was a coincidence between the two.” This differs from sicknesses like the flu or common cold, because those are upper respiratory infections, and are less likely to affect respiratory rate.

Turns out there was more going on. As more and more WHOOP users started reporting the same type of observations, the company decided it was time to do a little more digging. Together with the Cleveland Clinic and CQ University in Australia, WHOOP plans to conduct a study with 24/7 physiological data collected via the WHOOP strap from people with self-identified and confirmed cases of COVID-19.

“Obviously our preference would be to study as many confirmed cases as we can, but that will depend on the availability of testing,” Capodilupo says. Testing can be hard to come by without meeting strict criteria. The sample size of presumed cases is clearly much larger, but the accuracy of whether or not they’re actually experiencing COVID-19 is a little less clear.

Either way, all WHOOP users will have the ability to opt in to the study if they start experiencing symptoms of COVID-19, or are diagnosed with the virus. Typical symptoms include shortness of breath, fever, and a dry cough. When WHOOP members log in to their WHOOP Journal—an online interface connected to their smartphone allowing them to track and compare daily behaviors with physiological data—COVID-19 will be an option to monitor. They can also opt in to studies and surveys through the same interface, and opt out at any time.

If you don’t have a WHOOP, you’re probably wondering if your FitBit or Apple Watch can do the same thing, and the answer is a little unclear. WHOOP claims to be the only wearable device to validate the accuracy of its respiratory rate in a third party study. The study, published in the Journal of Clinical Sleep Medicine, determined that WHOOP could accurately measure sleep and cardiorespiratory variables, finding that the chance for error was very low in both. Some Garmin watches and FitBit models do measure respiratory rate, but most studies on the validity and reliability of fitness wearables have been inconclusive at best.

The coronavirus pandemic is a rapidly evolving situation, with new findings developing daily. We may not know a lot about it, but Bostonians everywhere are working hard to find answers and to keep this city safe. If you own a WHOOP, you’re encouraged to take part in the survey. If you have a different fitness wearable that measures respiratory heart rate, it’s unclear whether or not the information is reliable enough to predict a diagnosis. Regardless of your fitness wearables, continue carrying out social distancing measures, start wearing a mask when you leave your house, and wash your hands.