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Wearable Heart Rate Variability Monitoring, Autonomic Dysfunction and Post-exertional Malaise in Long COVID: An
Twan M Ruijgt1, Anouk Slaghekke1, Anneke Ellens2
1Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
Heart rate variability (HRV) monitoring reveals autonomic dysfunction in long COVID patients, with lower HRV during daily activities and delayed recovery after exercise. Wearables can help manage overexertion and post-exertional malaise (PEM).
Area of Science:
- Cardiology
- Neurology
- Physiology
Background:
- Long COVID is characterized by debilitating fatigue, autonomic dysfunction, and post-exertional malaise (PEM).
- Heart rate variability (HRV) is a key indicator of autonomic nervous system function and overexertion.
- Monitoring HRV may help manage PEM in long COVID patients.
Purpose of the Study:
- To investigate autonomic function in long COVID patients using continuous multi-day HRV recordings.
- To monitor overexertion and its impact on HRV in individuals with long COVID.
- To assess the relationship between exercise intensity and HRV recovery in long COVID.
Main Methods:
- Continuous heart rate and HRV measurements were collected from 121 long COVID patients and 21 healthy controls.
- Participants tracked daily activities and underwent cardiopulmonary exercise testing to determine the first ventilatory threshold (VT1).
- HRV responses to exercise at varying intensities around VT1 were analyzed.
Main Results:
- Long COVID patients exhibited significantly lower HRV compared to controls during daily activities and sleep.
- HRV remained depressed for 24 hours post-exercise in long COVID patients across all intensities around VT1.
- Intense exercise and longer durations led to decreased nighttime HRV in long COVID patients, indicating autonomic disturbances.
Conclusions:
- Wearable-assessed HRV indicates significant autonomic dysfunction in long COVID.
- Delayed sympathovagal balance recovery post-exercise suggests increased PEM risk above VT1.
- Wearables are applicable for assessing autonomic function and managing overexertion in long COVID.
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