The Duke University COVID-19 Research Taskforce is putting WHOOP straps on coronavirus patients to track how they are recovering from the disease, both in the hospital and after they are discharged.
Lead Clinical Medical Physiologist Dr. Jeroen Molinger joins the WHOOP Podcast to discuss this study, what the ICU experience is like, and why he’s particularly interested in tracking heart rate variability to learn more about the cardio-metabolic effects of a COVID-19 infection.
There’s still so much we don’t know about coronavirus and we’re eager to do our part to help researchers better understand this disease.
3:04 – Background. “Before COVID, we did our primary research in pre-operative care, looking at different metabolic phenotypes being at risk prior to major elective surgery. … Right now we have a completely different way of approaching [our work] because the operations here at Duke are minimal. There is no other research being done right now, all is focused on COVID.”
3:27 – Duke’s Coronavirus Research. “Right now, we’re looking at how we can define the systemic metabolic phenotype throughout the pre and post-infected period to define and dissect more where people are at risk. Why is there such a huge correlation with [body mass index] or social status and the worst outcomes we are seeing right now?”
4:19 – The Second Wave. “There will be people having organ failure coming from the ICU … having kidney problems, having liver problems, having congestive heart failure, cognition problems. [They will] return to work, having issues with quality of life, and if they get sick again, we could have a huge spike.”
5:10 – Impact of Being in ICU. “The chance of dying after your ICU admission, and that could be 8-12 months, is significantly higher, around 20 to 30 percent.”
8:14 – Appropriate Care. “We have to create survivors, not victims. We are creating victims if we are treating patients we already know are going to be having huge problems in regards to an ICU stay and have huge adverse effects and huge complications.”
8:56 – Intubating Patients. “Literally, we’re buying time. We have no cure yet, we cannot give anything for sure we know that helps. So what we’re doing with ventilation is just buying time to make sure that the body, if possible, can recover from this virus. Sometimes it does, and sometimes it doesn’t.”
9:19 – Body Mass Index and COVID-19. “One of the things we saw in The Netherlands, and we’ve also seen in New York, BMI was very well correlated with adverse outcomes. 80 percent of all admitted to the ICU in The Netherlands had a BMI larger than 30. We saw the same [numbers] in Italy and also in New York. One of the questions we had was, ‘Is BMI such a good predictor of having an adverse effect on ICU stays?”
10:42 – Heart Rate Variability and Coronavirus. “HRV could be a very good predictor of the immune response post-COVID. We have to have an ability to assess a large amount of patients. … We have to follow them up at home to see how they can be guided and supervised in their training, their nutrition, and their recovery.”
11:53 – Duke’s Study with WHOOP. Jeroen details Duke’s plans to use WHOOP to track patients recovering from COVID-19. “We will see what kind of outcomes we need to have to have a well-supervised, guided intervention at home. I am very curious to see, looking at the WHOOP outcomes, what the strain will look like in those patients from a day-to-day basis.”
13:29 – Wearing WHOOP on the Floor. “I’m wearing [a WHOOP] now. It’s a cool thing because I have the ability to see how I did before I went into the [patient] rooms. … It’s very helpful for me to see what I need to do. It’s vital that we stay safe also.”
14:53 – Study Goals. “We are trying to assess around 200 patients with 100 [members of a control group]. It will be a significant dataset. It’s important that we have a dataset not only from the home environment itself, but we can compare the home, to the [hospital] floor, and the ICU. … That’s novel. It’s never been done to look into those datasets and see how people change.”
17:23 – An Endemic Disease. “The COVID infection will never go away. Of course, we will have some vaccines for sure, but still, this is not going away at all.” Jeroen says it’s critical we learn more about our immune response to this disease.
19:57 – Antibody Testing & Unknown Cases. “One of the questions we have is how do you define ‘asymptomatic?’ Is it not having any symptoms at all? Or having a slight headache? Or a slight sore throat? This period of time is also the flu season, we have hay fever going on, we have a lot of bias surrounding people having these symptoms. The only way to make sure is testing. We have to be testing those people.”
23:10 – Tracking HRV Post-Coronavirus. Will and Jeroen discuss why an increase in heart rate variability can be a good sign after dealing with COVID-19, and why a decrease could be cause for concern. “We’d want to see their HRV stay flat or increase coming out of [coronavirus].”
24:29 – COVID-19’s Effect on Sleep. There is anecdotal evidence that coronavirus might cause intense nightmares and dreams. “We are seeing interesting analysis from that,” Will notes. “People are having these incredibly high fevers. High fevers can cause hallucinations and crazy dreams and that can show up in your WHOOP data.”
25:51 – Jeroen’s Pandemic WHOOP Data. “I have some drops in my recovery right now, but what I’m seeing that is very distinct is I’m very sensitive to my sleep hygiene. If I don’t get it, I instantly see my numbers in regard to recovery change.” Jeroen is working 14-hour days in the hospital during the pandemic.