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Heart rate variability follow-up during COVID-19: Case Report. Background: Being able to detect an early increase in the inflammatory response might prove to be vital in COVID-19 patients for mitigating its deleterious effects over time. Case: A 52-year-old man, obese, with moderate asthma and hypertension, who suffered COVID-19 with moderate symptoms used a wearable device to record his heart rate variability during his illness. He had a low parasympathetic tone, which decreased every day until it reached almost 2 standard deviations (SD) lower than normal, at the end of the second week. The sympathetic tone grew from more than 3 SD to more than 5 SD. Conclusions: These findings suggest that there might be an alteration in the modulation of the sympathetic and parasympathetic nervous systems, which apparently augments sympathetic tone and decreases parasympathetic tone. Population norms should be studied and published for COVID-19 patients over short-term and 24-h HRV measurements.