Clinical surrogates of dysautonomia predict lethal outcome in COVID-19 on intensive care unit

Fig. 1. Heart rate (HR) and mean arterial pressure (MAP) over time in COVID-19 patients who were treated in ICU. A Time course of HR and MAP over time in patients with COVID-19 who were admitted to the ICU. The data was separated into less than three days (early), three to ten days (intermediate) and more than 10 days (late) after admission to ICU. B–D Correlation analysis between the change rate of the HR and the change rate of the MAP in early (B; P = 0.007), intermediate (C; P = 0.0002) and late (D; P = 0.00014) timepoints. E standard deviation of HR (HRV) of survivors and non-survivors at early, intermediate, and late timepoints after admission to the ICU. F and standard deviation of MAP (BPV) of survivors and non-survivors less than two days (early), two to ten days (intermediate) and more than 10 days (late) after admission to the ICU. Statistical analyses were performed by mixed linear model corrected for age and sex and FDR-adjustment for multiple comparisons. *P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001

Fig. 2. Correlation of heart rate (HR) and mean arterial pressure (MAP) with laboratory parameters. Correlation of median, standard deviation, maximal and minimal HR (top 5 rows) and MAP (bottom 5 rows) per day with indicated laboratory parameters across all patients. Colour shows correlation coefficient R. Pearson correlation was used for statistical analysis and FDR-adjustment was performed for multiple comparisons. *P < 0.05, **P < 0.01, ***P < 0.001

Fig. 3. Heart rate variability (HRV) modulation dissociates from inflammation and respiratory failure in non-survivors. A and B Intraindividual correlation scores of HRV and each indicated laboratory parameter (top) and signed negative logarithmic P value (bottom). Dashed lines show P value of 0.05. C Comparison of all correlations of HRV with laboratory parameters between survivors and non-survivors. Unpaired t-test of − log10 P values was used for statistical comparison. D–E Correlation analyses of HRV with CRP (C), Procalcitonin (D) and blood carbon dioxide (E) separated by survivors and non-survivors. Pearson’s correlation analysis was performed. Group comparisons were performed by unpaired t-test of signed − log10 of the P value of intraindividual correlations. P values of correlation analyses and comparisons between survivors and non-survivors are depicted in the figure. *P < 0.05, **P < 0.01, ***P < 0.001