Heart-rate-variability (HRV), predicts outcomes in COVID-19

Area of Science:

• Neuroscience
• Immunology
• Cardiology

Background:

• COVID-19 presents with diverse clinical outcomes, posing challenges in identifying high-risk patients.
• The vagus nerve, a key neuro-immune modulator, influences inflammation and may impact COVID-19 severity.
• Heart rate variability (HRV) serves as a non-invasive index of vagus nerve activity.

Purpose of the Study:

• To investigate the prognostic value of HRV in predicting mortality and ICU referral in hospitalized COVID-19 patients.
• To assess HRV as a surrogate marker for vagus nerve activity in the context of COVID-19.
• To determine if HRV can identify patients at risk for adverse COVID-19 outcomes.

Main Methods:

• A retrospective cohort study of 271 COVID-19 patients hospitalized between March and May 2020.
• Exclusion criteria included cardiac arrhythmias, pacemaker use, and extreme heart rates (bradycardia/tachycardia).
• HRV was measured from a 10-second ECG at admission; 3-week survival and ICU referral were analyzed.

Main Results:

• Higher HRV, specifically standard deviation of normal to normal heartbeat intervals (SDNN), predicted survival (HR=0.53).
• This survival benefit was significant in patients aged 70 and older.
• Lower HRV values predicted ICU referral within the first week of hospitalization (HR=0.51, P=0.021).

Conclusions:

• Elevated HRV is associated with increased survival in COVID-19 patients, particularly the elderly.
• Reduced HRV is a significant predictor of ICU admission in the early stages of hospitalization.
• HRV offers valuable prognostic information for COVID-19 patient management, independent of other risk factors.