Patients with long COVID exhibited significantly lower heart rate variability during sleep (MD -8.82) and delayed autonomic recovery for 24 hours post-exercise compared to healthy controls.
Observational (n=142)
No
Does continuous wearable HRV monitoring detect autonomic dysfunction and exercise-induced disturbances in patients with long COVID compared to healthy controls?
Wearable-assessed HRV reveals autonomic dysfunction and delayed sympathovagal recovery after exercise in long COVID patients, suggesting its utility in managing post-exertional malaise.
Mean Difference: -8.82 (95% CI -16.58–-1.06)
p-value: p=0.027
Abstract Objectives Patients with long coronavirus disease (COVID) experience disabling fatigue, autonomic dysfunction, reduced exercise capacity and post-exertional malaise (PEM). Heart rate variability (HRV) can evaluate autonomic function and monitor overexertion, potentially helping to mitigate PEM. This study aimed to use continuous multi-day HRV recordings to monitor overexertion and study autonomic function in long COVID. Method Heart rate and HRV were continuously measured in 121 patients with long COVID (43 ± 11 years, 32% male) and 21 healthy controls (42 ± 13 years, 48% male), with daily life activities tracked in a logbook. Participants underwent a (sub)maximal cardiopulmonary exercise test to determine heart rate at the first ventilatory threshold (VT1) to study HRV responses to exercise at different intensities. Results and Discussion HRV was lower in patients with long COVID compared with healthy controls during various daily activities and sleep ( p = 0.027). Across all exercise intensities surrounding the VT1, HRV remained lower for 24 h in patients compared with controls ( p = 0.010). Nighttime HRV decreased with intense exercise and longer durations in patients with long COVID ( p = 0.018), indicative of exercise-induced diurnal disturbances of the autonomic nervous system in long COVID. Conclusion Heart rate variability, assessed by wearables, suggests autonomic dysfunction in patients with long COVID. The delayed recovery of the sympathovagal balance after exercise close to and above VT1, suggests that the risk of PEM rises above VT1. Application These results confirm the applicability of wearables to assess autonomic function and manage overexertion in patients with long COVID.
“But then why did they not property evaluate if patients had ME according to CC criteria? If it's real PENE/PEM they must have - and the study would be more meaningful than with a vague “long covid”. Also it seems very random. Of course HRV is lower with a chronic disease - I'm pretty sure it would also be for people who have a cold (and attempt exercise), have cancer, or anything else that messes with your system really.”
Ruijgt et al. (Sat,) conducted a observational in Long COVID (n=142). Long COVID vs. Healthy controls was evaluated on Heart rate variability (RMSSD) during sleep (MD -8.82, 95% CI -16.58 to -1.06, p=0.027). Patients with long COVID exhibited significantly lower heart rate variability during sleep (MD -8.82) and delayed autonomic recovery for 24 hours post-exercise compared to healthy controls.