Autonomic dysregulation in long-term patients suffering from Post-COVID-19 Syndrome assessed by heart rate variability.

Autonomic dysregulation in long-term patients suffering from Post-COVID-19 Syndrome assessed by heart rate variability.

Publication date: Sep 22, 2023

Post-COVID-19 Syndrome (PCS) is a condition with multiple symptoms partly related to dysregulation of the autonomic nerve system. Assessment of heart rate variability (HRV) using 24 h Holter-ECG may serve as a surrogate to characterize cardiac autonomic activity. A prospective study including 103 PCS patients (time after infection = 252 days, age = 49. 0 +/- 11. 3 years, 45. 7% women) was performed and patients underwent detailed clinical screening, cardiopulmonary exercise testing, and 24 h Holter monitoring. Data of PCS patients was compared to 103 CAD patients and a healthy control group (n = 90). After correction for age and sex, frequency-related variables differed in PCS patients compared to controls including LF/HFpower, LF/HFnu, and LF/HF ratio (24 h; p ≤ 0. 001). By contrast, these variables were largely comparable between PCS and CAD patients, while sympathetic activation was highest in PCS patients during the 24 h period. Overall, PCS patients showed disturbed diurnal adjustment of HRV, with impaired parasympathetic activity at night. Patients hospitalized during acute infection showed an even more pronounced overactivation of sympathetic activity compared to patients who underwent ambulant care. Our data demonstrate persistent HRV alterations in PCS patients with long-term symptom duration, suggesting a sustained impairment of sympathovagal balance. Moreover, sympathetic overstimulation and diminished parasympathetic response in long-term PCS patients are comparable to findings in CAD patients. Whether HRV variables have a prognostic value in PCS and/or might serve as biomarkers indicating a successful interventional approach warrants further longitudinal studies.

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Concepts Keywords
3years Activity
Biomarkers Autonomic
Cardiopulmonary Cad
Covid Compared
Women Covid


Type Source Name
disease MESH COVID-19
disease MESH Syndrome
disease VO time
disease VO frequency
disease IDO acute infection
disease IDO symptom
drug DRUGBANK Isoxaflutole
drug DRUGBANK Coenzyme M
disease MESH infection
disease MESH cognitive impairment
disease MESH psychological distress
disease VO population
disease IDO process
disease VO effective
disease VO Viruses
disease MESH dysautonomia
drug DRUGBANK Angiotensin II
disease MESH cardiovascular disease
disease IDO history
disease MESH functional status
disease IDO quality
disease VO ANOVA
disease VO age
disease VO M2
disease VO protocol
disease IDO blood
drug DRUGBANK Oxygen
drug DRUGBANK Carbon dioxide
disease IDO production
drug DRUGBANK Albendazole
disease MESH SD1
drug DRUGBANK Creatinine
drug DRUGBANK Urea
drug DRUGBANK Uric Acid
disease VO USA
disease MESH abnormalities
drug DRUGBANK Sulodexide
disease MESH hypertension
disease MESH diabetes mellitus
disease MESH pulmonary embolism
drug DRUGBANK Cholesterol
disease MESH adjustment disorders
drug DRUGBANK L-Valine
disease VO volume
disease MESH Coronary Artery Disease
disease MESH demyelination
disease MESH complications
disease MESH pathological processes
disease MESH viral infections
disease MESH tachycardia
disease MESH chest pain
disease MESH sinus tachycardia
disease MESH morbidity
disease MESH chronic fatigue syndrome
disease MESH fibromyalgia
disease MESH sleepiness
disease MESH long COVID
disease MESH Allergy
drug DRUGBANK L-Asparagine
disease MESH cytokine storm syndrome
drug DRUGBANK Hydroxyethyl Starch
disease MESH autoimmune diseases
disease MESH dilated cardiomyopathy
pathway KEGG Dilated cardiomyopathy
disease MESH sudden cardiac death
disease MESH myocardial infarction
disease MESH heart failure

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