Autonomic cardiac function in children and adolescents with long COVID: a case-controlled study

Area of Science:

• Cardiology
• Pediatrics
• Autonomic Neuroscience

Background:

• Long COVID presents with persistent symptoms, with autonomic dysfunction increasingly implicated in adults.
• Autonomic function in pediatric long COVID remains understudied, despite its potential role in long-term complications.

Purpose of the Study:

• To investigate cardiac autonomic function in pediatric patients diagnosed with long COVID.
• To compare heart rate variability (HRV) parameters between children with and without long COVID.

Main Methods:

• Fifty-six pediatric long COVID patients and 27 healthy controls underwent 12-lead ECG and 24-h Holter monitoring.
• Time-domain and frequency-domain HRV analyses were performed to assess autonomic cardiac function.
• Echocardiography was used to evaluate cardiac structure and function.

Main Results:

• Pediatric long COVID patients showed significant alterations in HRV parameters compared to controls.
• Specifically, lower r-MSSD and higher VLF, LF, and HF power were observed in the long COVID group.
• No significant differences in echocardiographic systolic or diastolic parameters were found between groups.

Conclusions:

• Pediatric long COVID is associated with cardiac autonomic imbalance, characterized by a relative parasympathetic predominance.
• This autonomic dysfunction in children mirrors findings in adult long COVID patients.
• Further research is needed to elucidate the clinical significance and therapeutic implications of this autonomic imbalance.