Practitioner Summary

De-identified

Participant: A
Condition (self-reported): long COVID
Period: 225 days of daily records
Wearables: ring, worn continuously (heart rate variability, resting heart rate, sleep, steps); watch, worn periodically (exercise)

In brief. A relapsing and remitting pattern with identifiable triggers. Throat and sinus symptoms were present every day. The cost of demanding days usually arrived 12 to 48 hours later, for physical, thinking, social and emotional demand alike. During a course of clinic-based therapy, resting heart rate rose 10 to 20 bpm and that period included the most severe stretch of the record. Stable days rose from 33% overall to 67% in the most recent three weeks, and recovery after crashes has become much faster.

For this consultation

Recovery is getting faster. After the first five crashes it took 10 to 17 days to return to a stable state; since around day 114 it has taken 1 to 7 days. What has changed, and how can it be sustained?
Throat and sinus symptoms persist every day, even as overall function improves. They may warrant separate review.
Damp indoor environments are a consistent trigger. Three of four dated exposures were followed by a worse next day.
Wearable data alone does not separate good days from bad ones for this person. Reported capacity is the better guide to decisions about activity.

Points the record suggests discussing. Not clinical advice.

Headline measures

225

days of continuous daily records

26%

of days functionally compromised (crash, amplified or depleted)

crash days requiring bed rest

33% → 67%

days in stable states: whole record, then the latest 21 days

1. Symptom severity

Symptom	Severe	Significant	Mild	Not present	Share of days

Each symptom is scored 0 to 4 twice a day against the participant's own symptom set. Each row splits all 225 days by the worst level that symptom reached that day, so the four figures add up to 100%. The bar shows the same split, in the colours shown in the column headings. Significant means significant but not severe.

How symptoms cluster

Throat and sinus symptoms move together and rise together after environmental exposures: the most stable finding in the record.

Emotional fragility comes first. A shift in emotional energy consistently came before the physical peak, making it an early warning sign.

Heaviness in the body (heavy, aching arms and eyes), often accompanied by headache, tracks with crash and amplified days.

2. Trajectory over time

Days	Stable states	Compromised (crash, amplified, depleted)	Crash days

Share of days in each 30-day block. The therapy course ran from day 53 to day 110. The final block covers 15 days.

Recovery after each crash

Days from each crash until the next day in a stable state. The 11th crash fell on the last day of the record, so its recovery is not yet known.

3. Day by day: state and wearable data

One cell per day. Hover or tap a day to see its state, capacity and symptom scores, resting heart rate and heart rate variability. A dark underline marks the therapy course (days 53 to 110); a purple dot marks a recorded environmental exposure.

Resting heart rate (bpm)

Heart rate variability (ms)

Thin line: daily value. Bold line: 7-day average. Shaded band: the therapy course. For this participant, heart rate variability tends to rise during flares rather than fall, so it is read alongside how the participant feels, not on its own.

Wearable data compared with lived experience

53 vs 55

average resting heart rate (bpm) on stable days vs compromised days

34 vs 33

average heart rate variability (ms) on stable days vs compromised days

compromised days when resting heart rate looked like a good day (50 bpm or below)

For this person, wearable averages barely differ between good and bad days. Without daily check-ins, many difficult days would have looked normal on the wearable alone.

4. Response to a treatment: course of clinic-based therapy (34 sessions)

Before (days 1 to 52)

average resting heart rate; heart rate variability 35 ms

During (days 53 to 110)

average resting heart rate (+10); above 60 bpm on 27 of 58 days; 4 crash days

After (day 111 onward)

average resting heart rate, gradually returning towards baseline; heart rate variability 33 ms

The therapy course coincided with the most functionally severe period of the record, and the treatment was discontinued. This is an association within one person's record, not evidence about the treatment in general.

5. Patterns over time

Delayed cost after demand	The most consistent finding: the cost of a demanding day usually arrived 12 to 48 hours later, whether the demand was physical, thinking, social or emotional. The participant often appeared to function well on the day itself.
Environmental exposure response	Damp indoor environments produced symptoms within 15 to 20 minutes (throat, headache, fatigue, emotional shift), with the following day usually worse than the day of exposure. Seven exposure events documented.
Early warning before crashes	Before 5 of 11 crashes, average heart rate variability over the previous three days was well above usual (40 ms or more, against a 34 ms average). For this person, a rise in heart rate variability can be an early warning rather than a sign of recovery.
Exercise threshold	Structured exercise was reintroduced successfully at moderate volume. A single high-volume session exceeded the current threshold and, with other demands in the same week, preceded a crash.
Helpful intervention	Deep tissue massage was consistently followed by better capacity and lower symptoms across several occasions.

Data quality and limits

Morning and evening check-ins across 225 days; 4 days without a classification. Wearable data on 213 days.
Several treatment and routine changes overlapped during the record, so their effects cannot always be separated.
Patterns are associations within one person's record. They are not diagnoses and do not establish cause.
Daily states were produced against PHIT's rule set and reviewed before publication during the trial.

PHIT helps people and their practitioners understand lived health over time. It does not diagnose, recommend treatment or make clinical decisions; use alongside your own assessment. This is a de-identified extract of a real PHIT practitioner report, shared with the participant's consent. The full report includes medication and test history, which is removed here.