“…After removing duplicates, 1585 results remained and were evaluated for title and abstract check. Therefore, 65 reports were considered in the full-text review stage, and 20 of those were included in the systematic review [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48], while 45 reports were excluded: 2 papers written in Russian [49,50], 5 conference papers [51][52][53][54][55], 3 comments [56][57][58], 4 case reports or case series [59][60][61][62], 2 literature reviews [63,64], 1 study protocol [65], 12 studies that did not perform a formal evaluation of autonomic functions [66][67][68][69][70][71][72][73][74][75]…”
Section: Study Selectionmentioning
confidence: 99%
“…[49,50]; study design-Refs. [51][52][53][54][55][56][57][58][59][60][61][62][63][64][65]; insufficient data regarding the autonomic involvement-Refs. [91][92][93].…”
Section: Study Selectionmentioning
confidence: 99%
“…; not in English or Italian-Refs [49,50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][91][92][93]…”
Although autonomic dysfunction (AD) after the recovery from Coronavirus disease 2019 (COVID-19) has been thoroughly described, few data are available regarding the involvement of the autonomic nervous system (ANS) during the acute phase of SARS-CoV-2 infection. The primary aim of this review was to summarize current knowledge regarding the AD occurring during acute COVID-19. Secondarily, we aimed to clarify the prognostic value of ANS involvement and the role of autonomic parameters in predicting SARS-CoV-2 infection. According to the PRISMA guidelines, we performed a systematic review across Scopus and PubMed databases, resulting in 1585 records. The records check and the analysis of included reports’ references allowed us to include 22 articles. The studies were widely heterogeneous for study population, dysautonomia assessment, and COVID-19 severity. Heart rate variability was the tool most frequently chosen to analyze autonomic parameters, followed by automated pupillometry. Most studies found ANS involvement during acute COVID-19, and AD was often related to a worse outcome. Further studies are needed to clarify the role of autonomic parameters in predicting SARS-CoV-2 infection. The evidence emerging from this review suggests that a complex autonomic nervous system imbalance is a prominent feature of acute COVID-19, often leading to a poor prognosis.
“…After removing duplicates, 1585 results remained and were evaluated for title and abstract check. Therefore, 65 reports were considered in the full-text review stage, and 20 of those were included in the systematic review [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48], while 45 reports were excluded: 2 papers written in Russian [49,50], 5 conference papers [51][52][53][54][55], 3 comments [56][57][58], 4 case reports or case series [59][60][61][62], 2 literature reviews [63,64], 1 study protocol [65], 12 studies that did not perform a formal evaluation of autonomic functions [66][67][68][69][70][71][72][73][74][75]…”
Section: Study Selectionmentioning
confidence: 99%
“…[49,50]; study design-Refs. [51][52][53][54][55][56][57][58][59][60][61][62][63][64][65]; insufficient data regarding the autonomic involvement-Refs. [91][92][93].…”
Section: Study Selectionmentioning
confidence: 99%
“…; not in English or Italian-Refs [49,50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][91][92][93]…”
Although autonomic dysfunction (AD) after the recovery from Coronavirus disease 2019 (COVID-19) has been thoroughly described, few data are available regarding the involvement of the autonomic nervous system (ANS) during the acute phase of SARS-CoV-2 infection. The primary aim of this review was to summarize current knowledge regarding the AD occurring during acute COVID-19. Secondarily, we aimed to clarify the prognostic value of ANS involvement and the role of autonomic parameters in predicting SARS-CoV-2 infection. According to the PRISMA guidelines, we performed a systematic review across Scopus and PubMed databases, resulting in 1585 records. The records check and the analysis of included reports’ references allowed us to include 22 articles. The studies were widely heterogeneous for study population, dysautonomia assessment, and COVID-19 severity. Heart rate variability was the tool most frequently chosen to analyze autonomic parameters, followed by automated pupillometry. Most studies found ANS involvement during acute COVID-19, and AD was often related to a worse outcome. Further studies are needed to clarify the role of autonomic parameters in predicting SARS-CoV-2 infection. The evidence emerging from this review suggests that a complex autonomic nervous system imbalance is a prominent feature of acute COVID-19, often leading to a poor prognosis.
“…Therefore the second sub-LF band contains the spectral energy analogs to the GImotility. The heat with a parasympathetic predominance by finger-induced auto thermogenesis [32] or using a steamgenerating sheet [33] as a therapeutic measure can enhance GI motility [33].…”
Cardiac autonomic regulation reflects in heart rate variability (HRV). The dysfunction in the regulation caused by type 2 diabetes mellitus (T2DM) shows a reduction in the amplitude of HRV. Resting HRV and fasting HbA1c are recorded for six T2DM subjects. Resting HRV is recorded for fifteen control subjects. When compared to control subjects, the T2DM subjects exhibit a significantly lower low frequency (LF) power (p < 0.05) and non-significantly lower high frequency (HF) power. Compared to HF-HRV, which has a correlation coefficient of -0.4109, the LF-HRV exhibits a positive correlation with HbA1c values of 0.9027. The sub-LF-HRV (0.062-0.084 Hz) has a correlation coefficient of 0.89 with HbA1c in contrast to the rest sub-bands. Similarly, the sub-HF-HRV (0.35-0.4Hz) has a correlation coefficient of -0.4375 with HbA1c in contrast to the sub-bands. The reconstructed time domain signal shows the periodic contraction and expansion of LF and HF signals mimicking the cardiac function.
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