Early Detection of COVID-19 in Female Athletes Using Wearable Technology.

BACKGROUND

Heart rate variability (HRV), respiratory rate (RR), and resting heart rate (RHR) are common variables measured by wrist-worn activity trackers to monitor health, fitness, and recovery in athletes. Variations in RR are observed in lower-respiratory infections, and preliminary data suggest changes in HRV and RR are linked to early detection of COVID-19 infection in nonathletes.

HYPOTHESIS

Wearable technology measuring HRV, RR, RHR, and recovery will be successful for early detection of COVID-19 in NCAA Division I female athletes.

STUDY DESIGN

Cohort study.

LEVEL OF EVIDENCE

Level 2.

METHODS

Female athletes wore WHOOP, Inc. bands through the 2020 to 2021 competitive season. Of the athletes who tested positive for COVID (n = 33), 14 had enough data to be assessed (N = 14; 20.0 ± 1.3 years; 69.8 ± 7.2 kg; 172.0 ± 8.3 cm). Roughly 2 weeks of noninfected days were used to set baseline levels of HRV, RR, recovery, and RHR to compare with -3, -2, and -1 days before a positive COVID-19 result.

RESULTS

Increases in RR ( = 0.02) were detected on day -3. RHR ( < 0.01) and RR increased ( < 0.01), while HRV decreased ( < 0.05) on day -1, compared with baseline. Differences were noted in all variables on the day of the positive COVID-19 result: decreased HRV ( < 0.05) and recovery scores ( < 0.01), and increased RHR ( < 0.01) and RR ( < 0.01).

CONCLUSION

In female athletes, wearable technology was successful in predicting COVID-19 infection through changes in RR 3 days before a positive test, and also HRV and RHR the day before a positive test.

CLINICAL RELEVANCE

Wearable technology may be used, as part of a multifaceted approach, for the early detection of COVID-19 in elite athletes through monitoring of HRV, RR, and RHR for overall team health.