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How did coronavirus disease 2019 affect autonomic balance in young individuals? Analysis by heart rate variability
İmran Ceren1, Fadime Bozduman Habip1
1Ankara Abdurrahman Yurtaslan Oncology Education and Research Hospital, Department of Cardiology - Ankara, Turkey.
Insights
Coronavirus disease 2019 (COVID-19) significantly impacts the cardiovascular autonomic system in young adults, leading to reduced heart rate variability and increased parasympathetic activity. This autonomic dysfunction may contribute to persistent symptoms following infection.
Area of Science:
- Cardiology
- Autonomic Nervous System Research
- Infectious Disease Impact
Background:
- The cardiovascular autonomic system's function can be affected by viral infections.
- Long-term symptoms post-COVID-19 warrant investigation into underlying physiological changes.
Purpose of the Study:
- To investigate the effects of COVID-19 on heart rate variability (HRV) in young individuals.
- To assess alterations in the cardiovascular autonomic system after COVID-19 infection.
Main Methods:
- Retrospective analysis of 24-hour Holter ECG records from 492 young COVID-19 patients with prolonged symptoms.
- Comparison with 401 age-matched controls from the pre-pandemic era.
- Evaluation of HRV parameters, including standard deviation of normal RR intervals (SDNN) and frequency domain measures.
Main Results:
- COVID-19 patients exhibited a higher prevalence of reduced SDNN (≤100 ms) compared to controls (14.8% vs 6.7%).
- COVID-19 presence and age were significant predictors of reduced SDNN.
- Elevated high-frequency values and a lower low-frequency/high-frequency ratio were observed in the COVID-19 group, indicating increased parasympathetic activity.
Conclusions:
- COVID-19 infection is associated with reduced heart rate variability in young individuals.
- Increased parasympathetic activity is a notable finding post-COVID-19.
- These autonomic changes may contribute to the persistence of symptoms after COVID-19.
Objective:
The aim of this study was to demonstrate the effect of coronavirus disease 2019 on the cardiovascular autonomic system using heart rate variability in young individuals.
Methods:
The study was designed retrospectively by scanning the 24-h Holter electrocardiography records of patients who applied to the Ankara Abdurrahman Yurtaslan Oncology Education and Research Hospital Cardiology outpatient clinic. The study group consisted of 492 patients under the age of 40 years, who did not have additional comorbidities or medication use and had prolonged symptoms after coronavirus disease 2019 during the pandemic. The control group, including 401 patients, was determined during the pre-pandemic period (before December 2019). Heart rate variability parameters were evaluated by scanning the 24-h Holter electrocardiography records of the patients and compared with the non-coronavirus disease 2019 group.
Results:
The median age of participants was 30 years. Standard deviation of normal RR intervals (SDNN) ≤100 ms was more prevalent in the study group (27 (6.7%) vs 73 (14.8%), p<0.001). In univariate logistic regression analysis, the presence of coronavirus disease 2019 [(OR 2.41, 95%CI 1.52-3.83), p<0.001] and age [(OR 1.04, 95%CI 1.01-1.07), p=0.016] had a significant effect on the probability of SDNN≤100. In multivariate logistic regression analysis, the presence of coronavirus disease 2019 [(OR 2.42, 95%CI 1.52-3.85), p<0.001] and age [(OR 2.42, 95%CI 1.52-3.85), p=0.016] had a significant effect on the probability of SDNN≤100. Frequency domain measures such as, high-frequency values were significantly higher in the study group (p=0.029). The study group's low-frequency/high frequency ratio was significantly lower (p=0.019). The low-frequency/high-frequency ratio's cut-off value was ≤2.77. for determining the differentiation between coronavirus disease 2019 positive and negative cases in the receiver operating characteristic analysis. The sensitivity rate was 80.7%. The area under the curve value is 0.546 (p=0.019).
Conclusion:
This study showed that coronavirus disease 2019 causes reduced heart rate variability and increased parasympathetic activity in young patients. This may explain the prolonged symptoms after coronavirus disease 2019 infection.
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