How respiratory rate trends can flag earlier COVID warning signs

Originally published on December 8, 2020

Respiratory rate can help flag changes in health earlier, and this article explains what WHOOP research found, which patterns matter most, and how pro golfer Scott Stallings used his data to decide to get tested for COVID-19. In Episode 102 of the WHOOP Podcast, Senior Vice President of Research, Algorithms, and Data at WHOOP Emily Capodilupo breaks down a peer-reviewed study in PLOS ONE, while Stallings shares a clear real-world example of a respiratory rate spike, a drop in HRV, and a jump in resting heart rate that pointed to illness before he would have otherwise acted.

Note: This article covers WHOOP Strap 3.0. For the latest hardware, see the latest WHOOP hardware.

To listen to episode 102 in full, head to the WHOOP Podcast on Spotify.

Why is respiratory rate such a useful baseline metric?

Respiratory rate is useful because it stays unusually stable from night to night in healthy people. That stability makes even modest changes easier to spot against your own baseline.

Capodilupo explains that the key insight came from a large pre-pandemic dataset. In a PLOS ONE study on respiratory rate and COVID-19, researchers from WHOOP examined 25,000 WHOOP members who recorded data across all 30 days of November 2019. The average standard deviation in nightly respiratory rate was about 0.5 breaths per minute, which means most people show very little natural drift from one night to the next. Earlier reporting in The Importance of Respiratory Rate Tracking During COVID-19 set up the same idea, but the peer-reviewed paper gave it firmer footing.

Capodilupo summarized the baseline finding this way:

“What we found is that the average WHOOP member standard deviation was about half of a breath per minute.”

What you should take away

• Respiratory rate is valuable because it usually changes less from night to night than many other health metrics.
• WHOOP compares respiratory rate to your own typical range, not to a single population cutoff.
• A stable baseline makes it easier to notice when a new health stressor starts to push the metric upward.

If you want to hear Capodilupo unpack how stable respiratory rate is from night to night, listen to the full episode on Spotify.

What respiratory rate pattern can point to COVID-19?

Once you know respiratory rate is stable, the next question is what kind of change deserves attention. The signal Capodilupo highlights is a gradual rise over a few nights, followed by a larger spike around symptom onset.

The same PLOS ONE paper tracked 270 people who reported COVID-19 symptoms and then got tested. Of that group, 81 tested positive. Researchers looked at respiratory rate from two nights before symptoms started through three days into illness. The repeated pattern in positive cases was a steady climb, while people who felt sick but later tested negative usually did not show that same shape. The algorithm identified 80% of symptomatic COVID-19 cases in the study. Capodilupo also warns that the evidence came from symptomatic cases, so a normal trend does not clear someone of infection.

As Capodilupo puts it:

“When respiratory rate suddenly increases, and particularly when it increases in this interesting gradual pattern over the course of a couple nights, it’s the sustained increase that can be indicative of COVID-19.”

For more real-world examples of that rise-and-spike pattern, see Knowing Your Baseline: Case Studies in Respiratory Rate in Time of COVID-19.

What you should take away

• The most useful pattern is a sustained rise across several nights, not a single isolated high reading.
• WHOOP research found that an elevated respiratory rate pattern identified 80% of symptomatic COVID-19 cases in the study sample.
• A normal respiratory rate trend does not rule out asymptomatic COVID-19.

If you want to hear Capodilupo go deeper on the incubation pattern behind respiratory rate spikes, listen to the full episode on Spotify.

What else can make respiratory rate go up on WHOOP?

That pattern is important, but it still needs context. A respiratory rate spike can reflect something other than COVID-19, which is why WHOOP shows the metric against your normal range and why it helps to look at the full picture.

Capodilupo points to environmental shifts first. A sudden drop in air quality, including smoke exposure, can push respiratory rate higher because your lungs have to work harder to get oxygen into the bloodstream. She also mentions temperature changes, medication changes, smoking, and other lower respiratory tract infections such as pneumonia. In this conversation, Will Ahmed also flags altitude and heavy drinking as possible contributors. That same broader context is part of the reason respiratory rate later became a factor in Recovery, as covered in WHOOP Recovery Update: Respiratory Rate Added.

Capodilupo gives the simplest version of the false-alarm check here:

“Any kind of acute change in your air quality and even in temperature can change your respiratory rate.”

What you should take away

• Respiratory rate can rise because of air quality, temperature, medication changes, smoking, or another lower respiratory infection.
• WHOOP trends are most useful when you compare the spike with recent travel, sleep context, symptoms, and other metrics.
• A single elevated night should prompt attention, but the pattern across several nights is more informative.

If you want to hear Capodilupo unpack which non-COVID factors can move respiratory rate, listen to the full episode on Spotify.

How did Scott Stallings use WHOOP data to decide to get tested and guide recovery?

After the research discussion, Stallings shows what this looks like in practice. He had a low-key day, slept about eight hours, woke up to a respiratory rate of 19, and immediately knew the data looked wrong for him.

Stallings says his November baseline respiratory rate was 16.7 and had stayed flat for most of the month. On the morning he chose to get tested, his HRV was down about 40 points, his resting heart rate was up about 10 beats per minute, and his Recovery was 11. He called Dr. Kevin Sprouse, got tested that afternoon, and learned he was positive. For Stallings, the spike mattered because it arrived without the usual explanation of heavy training, travel, or a late night. His story also shows why it helps to read respiratory rate alongside HRV, resting heart rate, and Recovery. Related reporting in What WHOOP Can Tell You About COVID-19 covers the same multi-metric pattern across a larger set of member data.

Stallings described the morning this way:

“I woke up and my respiratory rate was 19. My HRV was 40 points down, my resting heart rate was 10 points up, and my recovery was 11.”

Later in quarantine, Stallings kept using the same trend lines to judge his return. He said his respiratory rate came back down first, resting heart rate moved toward baseline, and HRV took longer to recover. That sequence matches what many people see after illness, where symptoms can fade before every metric fully rebounds.

What you should take away

• Scott Stallings chose to get tested because several WHOOP metrics moved sharply in the wrong direction at the same time.
• Stallings saw respiratory rate jump from a baseline near 16.7 to 19 on the day he tested positive.
• Respiratory rate, HRV, resting heart rate, and Recovery can help frame both the onset of illness and the return toward baseline.

If you want to hear Stallings go deeper on using WHOOP data during quarantine and return, listen to the full episode on Spotify.

The bottom line

• Respiratory rate is one of the most stable nightly metrics WHOOP tracks, which makes baseline changes easier to spot.
• Research from WHOOP published in PLOS ONE found an average nightly respiratory rate standard deviation of about 0.5 breaths per minute across 25,000 members.
• The respiratory rate pattern linked to COVID-19 in this study was a gradual rise over several nights followed by a larger spike near symptom onset.
• The elevated respiratory rate algorithm identified 80% of symptomatic COVID-19 cases in the study population.
• A normal respiratory rate trend does not rule out asymptomatic infection, so a flat line should not be treated as a clearance signal.
• Air quality, temperature, medications, smoking, altitude, heavy drinking, and other lower respiratory infections can also raise respiratory rate.
• Scott Stallings used a jump from a 16.7 baseline to 19 breaths per minute, plus a sharp HRV drop and higher resting heart rate, to decide to get tested.
• Recovery after illness can show up in WHOOP as respiratory rate normalizing before HRV fully returns to baseline.

Frequently asked questions about things discussed in this episode

How does WHOOP define a respiratory rate increase that matters?

WHOOP defines a meaningful respiratory rate increase against your typical range, so the useful signal is a change from your own baseline rather than a universal cutoff.

What does WHOOP research show about respiratory rate and COVID-19?

WHOOP research published in PLOS ONE found that a sustained rise in respiratory rate identified 80% of symptomatic COVID-19 cases in the study sample.

What does WHOOP do if your respiratory rate stays normal?

WHOOP shows a stable trend as part of your baseline, but a normal respiratory rate does not clear you of asymptomatic COVID-19.

How does WHOOP help you interpret respiratory rate alongside other metrics?

WHOOP helps by showing respiratory rate next to HRV, resting heart rate, and Recovery, which makes it easier to see whether several signals are moving together.

What does WHOOP suggest you do after a sudden respiratory rate spike?

WHOOP data can serve as an early warning sign, so a sudden spike is a reason to pay closer attention, reduce unnecessary contact, and consider medical follow-up or testing.

What does WHOOP show during recovery after illness?

WHOOP often shows recovery as a return toward baseline across respiratory rate, resting heart rate, HRV, and Recovery, with HRV sometimes taking longer to rebound.

For respiratory rate, the value is in the baseline, and WHOOP makes it easier to see when your nightly trend stops looking like you.