Key result
Autonomic dysfunction, indicated by reduced heart rate variability, was significantly associated with pulmonary diffusion dysfunction and pulmonary fibrosis in patients 6 months after discharge for COVID-19.
Why the study?
Although autonomic dysfunction is associated with acute disease severity in COVID-19, its relationship with post-discharge pulmonary sequelae remained unknown.
Cohort (n=40)
No
p-value: p=<0.01
Autonomic dysfunction, as measured by reduced heart rate variability, is closely associated with pulmonary fibrosis and diffusion dysfunction in COVID-19 survivors 6 months post-discharge.
Autonomic dysfunction may link to post-COVID pulmonary sequelae; hypothesis-generating and requires validation in larger prospective cohorts.
Previous studies suggest that autonomic dysfunction is associated with disease severity in acute phase in patients with coronavirus disease 2019 (COVID-19). However, the association between autonomic dysfunction and pulmonary sequelae in patients with COVID-19 is unknown. We conducted a prospective study to investigate the association between autonomic dysfunction and pulmonary sequelae in patients with COVID-19 discharged for 6 months. We included 40 eligible participants and collected the following indicators: heart rate variability (HRV), pulmonary function tests (PFTs), lung X-ray computed tomography (CT), routine blood parameters, liver function parameters, and lymphocyte subsets. We found that at 6 months post-discharge, HRV still had a tight correlation with pulmonary fibrosis. There was a significant difference in HRV between patients with and without diffusion dysfunction, but HRV did not differ between patients with or without ventilatory dysfunction. Diffusion dysfunction and pulmonary fibrosis were tightly associated, and HRV index changes in patients with diffusion dysfunction had the same trend as that of patients with pulmonary fibrosis. They had a lower standard deviation of NN intervals (SDNN), the standard deviation of the average NN intervals (SDANN), and the triangular index, but a higher ratio between LF and HF power (LF/HF). In addition, WBC, neutrophils, and CD4/CD8 were correlated with pulmonary fibrosis and HRV. We concluded that autonomic dysfunction is closely associated with pulmonary fibrosis and diffusion dysfunction, and immune mechanisms may potentially contribute to this process.
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Bai et al. (2022) conducted a cohort in COVID-19 pulmonary sequelae (n=40). Autonomic dysfunction (measured by Heart Rate Variability) vs. Normal autonomic function was evaluated on Pulmonary fibrosis and diffusion dysfunction (p=<0.01). Autonomic dysfunction, indicated by reduced heart rate variability, was significantly associated with pulmonary diffusion dysfunction and pulmonary fibrosis in patients 6 months after discharge for COVID-19.
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