Hospitalized Patients With Covid-19 Have Changes In The Cardiac Autonomic Control? A Cohort Study

Objectives: To evaluate cardiac autonomic control through heart rate variability (HRV) in hospitalized patients with COVID-19 and compare, considering the severity.Methods: This is an observational and cohort study.All patients with suspected and diagnosed COVID-19 were invited to participate as soon as they arrived at the hospital.The HRV was recorded at rest in the supine position for 10 minutes using a cardio frequency (Polar S810i, Kempele, Oulu, Finland).Patients were followed until death or discharge.Results: 120 patients were evaluated, of which 60 were in the Non-COVID-19 group and 60 patients in the COVID-19 group.The COVID-19 group was divided according to severity (30 patients were classified as mild-to-moderate and 30 as severe-to-critical).The COVID-19 group remained hospitalized longer (p<0.01),had a higher mortality rate (p<0.01),more excellent sympathetic modulation (LF, nu) (p < 0.01), sympathovagal balance (LF/HF) (p=0.01) and lower parasympathetic modulation (HF, nu) (p < 0.01) compared to the Non-COVID-19 group.In COVID subgroups, the severe/critical COVID-19 group had higher sympathetic activity (LF, nu) (p=0.01) and lower parasympathetic activity (HF, nu) (p=0.01)compared to patients in the mild/moderate COVID-19.Conclusion: Patients hospitalized with COVID-19 for up to 48 hours had sympathovagal imbalance found through HF (nu), LF (nu), and HF/LF.In addition, the more severe patients had more significant impairment of cardiac autonomic control and consequently had lower total HRV and more excellent sympathetic modulation. Highlights1.This is the first study that evaluated early HRV in hospitalized patients with COVID-19.2. Patients with COVID-19 had marked cardiac autonomic dysfunction.3. The more severe patients had more significant impairment of cardiac autonomic control.