Key result
Post-acute paucisymptomatic COVID-19 is linked to reduced HRV, marked by higher LF/HF and lower SDNN.
Why the study?
Autonomic nervous system activity after paucisymptomatic COVID-19 infection in healthcare workers was not well characterized.
Does paucisymptomatic COVID-19 infection alter autonomic nervous system activity (HRV) in healthcare workers during the post-acute phase?
Case-Control (n=88)
Does paucisymptomatic COVID-19 infection alter autonomic nervous system activity (HRV) in healthcare workers during the post-acute phase?
p-value: p=0.006
Paucisymptomatic COVID-19 infection is associated with persistent autonomic imbalance characterized by reduced heart rate variability in the post-acute phase, potentially contributing to acute cardiovascular complications.
May suggest post-COVID autonomic changes in HCWs; hypothesis-generating and requires prospective validation before clinical relevance.
Healthcare workers (HCWs) represent a population with a significant burden of paucisymptomatic COVID-19, as the general population. We evaluated autonomic nervous system activity by means of heart rate variability (HRV) in HCWs during health surveillance visits. Short-term electrocardiogram (ECG) recordings were obtained 30 days (IQR 5.25–55.75) after a negative naso-pharyngeal swab for SARS-CoV-2 in 44 cases and compared with ECGs of 44 controls with similar age and sex distribution. Time and frequency domain HRV were evaluated. HCWs who used drugs, had comorbidities that affected HRV, or were hospitalized with severe COVID-19 were excluded. Frequency domain HRV analysis showed a significantly higher low/high-frequency power ratio (LF/HF) in the case study compared with controls (t = 2.84, p = 0.006). In time domain HRV analysis, mean standard deviation of normal-to-normal intervals (SDNN) and root mean square of successive RR interval differences (RMSSD) were significantly lower for cases compared with controls (t = −2.64, p = 0.01 and t = −3.27, p = 0.002, respectively). In the post-acute phase of infection, SARS-CoV-2 produces an autonomic imbalance mirrored by a reduction in HRV. These results are consistent with epidemiological data that suggest a higher risk of acute cardiovascular complications in the first 30 days after COVID-19 infection.
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Liviero et al. (2023) conducted a case-control in Post-acute COVID-19 (n=88). Post-acute paucisymptomatic COVID-19 vs. Controls without COVID-19 was evaluated on Low/high-frequency power ratio (LF/HF) (p=0.006). Post-acute paucisymptomatic COVID-19 was associated with reduced heart rate variability, including a higher LF/HF ratio (p=0.006) and lower SDNN (p=0.01) compared with controls.
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