Key result
COVID-19 infection was significantly associated with increased parasympathetic activity (rMSSD>40) compared to healthy controls (adjusted OR 7.609; 95% CI 1.61-35.94; p=0.01).
Why the study?
COVID-19 affects the cardiovascular system and may cause dysautonomia via hypothalamic-pituitary axis involvement, prompting evaluation of heart rate variability to identify patients at risk of cardiovascular complications.
Does COVID-19 infection alter heart rate variability compared to healthy controls?
Case-Control (n=106)
Does COVID-19 infection alter heart rate variability compared to healthy controls?
Odds Ratio: 7.609 (95% CI 1.61–35.94)
p-value: p=0.01
COVID-19 infection is associated with increased parasympathetic tone as measured by heart rate variability, indicating early autonomic imbalance.
May indicate autonomic involvement in COVID-19; leaves open whether HRV changes predict outcomes or warrant intervention.
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.
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RK et al. (2021) conducted a case-control in COVID-19 (n=106). COVID-19 infection vs. Healthy controls was evaluated on Increased parasympathetic activity defined by rMSSD>40 (adjusted OR 7.609, 95% CI 1.61-35.94, p=0.01). COVID-19 infection was significantly associated with increased parasympathetic activity (rMSSD>40) compared to healthy controls (adjusted OR 7.609; 95% CI 1.61-35.94; p=0.01).
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