Heart Rate Variability Is Reduced 3- And 6-Months After Hospitalization for Covid-19 Infection

Adler, T.; Norcliffe‐Kaufmann, Lucy; Condos, Rany; Fishman, Glenn I.; Kwak, David; Talmor, Nina; Reynolds, Harmony R.

doi:10.1016/s0735-1097(21)04417-x

Cited by 13 publications

(19 citation statements)

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“…The study population was divided into two groups: controls (n=31) who neither tested positive nor had a history of COVID-19 before, and post-COVID patients (n=28) who tested positive PCR for COVID-19 at least 3 months before recruitment. We determined the sample size based on previous studies with comparable outcomes, where the sample size ranged from 25 19 to 152 22 participants.…”

Section: Methodsmentioning

confidence: 99%

“… 18 Additionally, Adler et al reported a reduction in the HRV among post-COVID patients 3 and 6 months after recovery, which may increase the cardiovascular risk among post-COVID survivors. 19 In contrast, parasympathetic overactivity with increased HRV was found after 12 weeks from the acute COVID-19 infection. 20 Cardiovascular dysautonomia was also detected in about 15% of recently recovered COVID-19 patients (within 30–45 days), with a significantly lower HRV compared to healthy controls.…”

Section: Introductionmentioning

confidence: 94%

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Post-Acute Effect of SARS-CoV-2 Infection on the Cardiac Autonomic Function

Salem¹,

Yar²,

Eid³

et al. 2022

IJGM

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Background Recent studies reported a long-lasting effect of COVID-19 infection that extends beyond the active disease and disrupts various body systems besides the respiratory system. The current study aims to investigate the post-acute effect of SARS-CoV-2 infection on cardiovascular autonomic activity, reactivity and sensitivity in patients who had the infection at least 3 months before. Methods This was a comparative cross-sectional observational study. Fifty-nine subjects were allocated into two groups, controls (n=31), who had no history of positive COVID-19 infection, and the post-COVID patients (n=28) who were recruited 3 to 8 months after testing positive for SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR). Baseline cardiovascular autonomic activity was evaluated through recording of baseline heart rate variability (HRV), autonomic reactivity was determined through standard cardiovascular autonomic reflex tests (CART), and cardiac autonomic sensitivity was assessed through cardiac baroreceptor sensitivity (cBRS). Results Higher incidence of orthostatic hypotension was observed in post-COVID patients compared to controls (39.3% and 3.2%, respectively, p <0.001). Additionally, significantly reduced handgrip test, and heart rate response to head-up tilt was illustrated in the post-COVID group (p <0.001). About 85.7% of post-COVID participants had at least one abnormal cardiovascular reflex test (CART) compared to the control group (p <0.001). Although HRV parameters (TP, LF, HF, SDRR, RMSSD, pRR50), and the cBRS were numerically lower in the post-COVID-19 group, this did not reach the level of significance. Conclusion The results of the present study are suggestive of altered cardiovascular reactivity in post-acute COVID patients and demand further investigation and longer term follow up.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

Post-Acute Effect of SARS-CoV-2 Infection on the Cardiac Autonomic Function

Salem¹,

Yar²,

Eid³

et al. 2022

IJGM

View full text Add to dashboard Cite

show abstract

“…444 Also, impaired parasympathetic modulation of HRV has been observed after COVID-19 infection through 6 months post-discharge. 445  The activation of stress response programs in PASC patients has been suggested in a study of immune parameters based on the expression of AP-1 and DDIT4 genes 426  It seems that neuroinflammation with activation of innate and adaptive immune cells plays a role in acute Covid 19 446,447 but also in PASC, as evidenced by gene ontology network analyses which highlights neuroinflammatory responses. 448 It has been suggested that neuroinflammation may influence neurological sequelae in PASC by altering nEV proteins (neuronal-enriched extracellular vesicle proteins).…”

Section: Covid-19 To the Rescuementioning

confidence: 99%

Broken Connections: The Evidence for Neuroglial Failure in ME/CFS

Renz‐Polster¹

2021

Preprint

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In spite of decades of research, the pathobiology of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is still poorly understood. Several pathomechanisms have been identified, yet, it remains unclear how they are related and which of them may be upstream or downstream.. In this paper, we present a theoretical strategy that may help clarify the causal chain of pathophysiological events in ME/CFS. We propose to focus on the common final histological pathway of ME/CFS and suggest to ask: Which cellular compartment may explain the pathological processes and clinical manifestations observed in ME/CFS? Any functional unit consistently identified through this search may then be a plausible candidate for further exploration.For this "histological" approach we have compiled a list of 22 undisputed clinical and pathophysiological features of ME/CFS that need to be plausibly and most directly explained by the dysfunctional cellular unit in question. For each feature we have searched the literature for pathophysiological explanations and analyzed if they may point to the same functional cellular unit.Through this search we have identified the CNS neuroglia - microglia and astroglia - as the one functional unit in the human body which may best explain all and any of the clinical and pathological features, dysfunctions and observations described for ME/CFS. While this points to neuroinflammation as the central hub in ME/CFS, it also points to a novel understanding of the neuroimmune basis of ME/CFS. After all, the neuroglial cells are now understood as the functional matrix of the human brain connectome which operates beyond and above specific brain centers, receptor units or neurotransmitter systems and integrates innate immune functions with CNS regulatory functions pertaining to autonomous regulation, cellular metabolism and the stress response.

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“…HRV is the measurement of the variability of these N–N intervals. Some recent studies have indicated change in heart rate variability (HRV) in COVID-recovered subjects [ [28] , [29] , [30] ]. This indicates that tracking of the heart status of post-COVID recovered subjects can help in providing timely assistance to these subjects for better survival.…”

Section: Introductionmentioning

confidence: 99%