Characterization of cardiac autonomic function in COVID-19 using heart rate variability: a hospital based preliminary observational study
Author:
Kaliyaperumal Deepalakshmi1, RK Karthikeyan2, Alagesan Murali3, Ramalingam Sudha4
Affiliation:
1. Physiology , PSG Institute of Medical Sciences and Research , Coimbatore , Tamil Nadu , India 2. Respiratory Medicine , PSG Institute of Medical Sciences and Research , Coimbatore , Tamil Nadu , India 3. Internal Medicine , PSG Institute of Medical Sciences and Research , Coimbatore , Tamil Nadu , India 4. Research and Innovation , PSG Institute of Medical Sciences and Research , Coimbatore , Tamil Nadu , India
Abstract
Abstract
Objectives
The novel corona virus disease, which was initially reported in China in late 2019, has become a global pandemic affecting 330 million cases. COVID-19 affects predominantly the respiratory system, in addition to other organ systems, mainly the cardiovascular system. One of the hypotheses is that virus entering the target cells by binding to angiotensin converting enzyme 2 affecting hypothalamic pituitary axis could lead to dysautonomia which is measured by heart rate variability (HRV). HRV is a non-invasive measure of autonomic function that facilitates identification of COVID-19 patients at the risk of developing cardiovascular complications. So, we aimed to assess HRV in COVID patients and compare between COVID patients and normal controls.
Methods
In a case control design, we compared 63 COVID-19 infected patients with 43 healthy controls matched for age and gender. Along with clinical characterization, heart rate variability was evaluated using ambulatory 5 min ECG in lead II and expressed in frequency and time domain measures. Statistical analysis was performed using SPSS 17.0.
Results
Mean age of the study population was 49.1 ± 14.2 years and 71 (66.9%) were males. Frequency domain measures high (HF) and low (LF) frequency powers were significantly decreased in COVID-19 patients compared to controls. HF/LF and LF/HF ratios were not different between groups. Time domain measures rMSSD (root mean square of successive RR interval differences) and SDNN (standard deviation of NN intervals) were significantly increased among COVID-19 subjects. COVID-19 infection was associated with increased parasympathetic activity as defined by rMSSD>40 {adjusted odds ratio 7.609 (95% CI 1.61–35.94); p=0.01} and SDNN>60 {adjusted odds ratio 2.620 (95% CI 1.070–6.44); p=0.035} after adjusting for age, gender and comorbidities.
Conclusions
Our study results showed increased parasympathetic tone in COVID patients. Early diagnosis of autonomic imbalance in COVID patients is needed to plan management and limit progression of disease.
Publisher
Walter de Gruyter GmbH
Subject
Drug Discovery,Pharmacology,General Medicine,Physiology
Reference46 articles.
1. Huang, C, Wang, Y, Li, X, Ren, L, Zhao, J, Hu, Y, et al.. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497–506. https://doi.org/10.1016/s0140-6736(20)30183-5. 2. Wang, C, Horby, PW, Hayden, FG, Gao, GF. A novel coronavirus outbreak of global health concern. Lancet 2020;395:470–3. https://doi.org/10.1016/s0140-6736(20)30185-9. 3. Su, S, Wong, G, Shi, W, Liu, J, Lai, ACK, Zhou, J, et al.. Epidemiology, genetic recombination, and pathogenesis of coronaviruses. Trends Microbiol 2016;24:490–502. https://doi.org/10.1016/j.tim.2016.03.003. 4. Gorbalenya, AE, Baker, SC, Baric, RS, Groot, RJ, Drosten, C, Gulyaeva, AA, et al.. Severe acute respiratory syndrome-related coronavirus: the species and its viruses: a statement of the Coronavirus Study Group. Nat Microbiol 2020;5:536–44. 5. Wang, D, Hu, B, Hu, C, Zhu, F, Liu, X, Zhang, J, et al.. Clinical characteristics of 138 hospitalized patients with 2019 novel corona virus-infected pneumonia in Wuhan, China. JAMA J Am Med Assoc 2020;323:1061–9. https://doi.org/10.1001/jama.2020.1585.
Cited by
52 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|