Relative bradycardia in patients with COVID-19

Abstract

Introduction Relative bradycardia(RB) is a relatively low heart rate response to rise in body temperature that occurs in several infectious diseases and can be an important clinical sign. In previous case reports, RB was presented in some patients with Coronavirus disease 2019 (COVID-19) COVID-19. Objective and Methods To investigate the correlation between temperature and heart rate, we retrospectively reviewed 249 febrile patients with documented COVID-19 patients. RB was defined as a rise in the heart rate from a basal heart rate of less than 10 beats/minute/°C rise in temperature. Results In this study, the prevalence of RB in patients with COVID-19 was 60.6%. When the HR at peak temperatures for patients with COVID-19 were compared with reference valve (general temperature-heart rate response in infectious disease), our findings demonstrate a relatively lower heart rate at all peak temperatures recorded. Despite differences in heart rate response, there were not significant differences in clinical outcomes (pulmonary manifestation, intensive care unit admission, Death). Conclusions Most patients with COVID-19 are associated with relative bradycardia, not related to clinical outcomes. RB in COVID-19 can be considered as the clinical features for differential diagnosis from other febrile conditions.

The Clinical Utility of Relative Bradycardia for Identifying Cases of Coronavirus Disease 2019 Pneumonia: A Retrospective Pneumonia Cohort Study

“…We had considered relative bradycardia a more common symptom of COVID-19 than other infectious pneumonia. Relative bradycardia has been reported in nearly 60% of cases of COVID-19 ( 6 , 18 ). There are three possible reasons for the discrepancy between these findings and the results of this study.…”

Unmasking Pandemic Echoes: An In-Depth Review of Long COVID’s Unabated Cardiovascular Consequences beyond 2020

“…Relative bradycardia (RB) is another phenomenon different from BA, being characterized by an abnormal response to high body temperature observed in various infectious diseases, including COVID-19 [128]. Several definitions have been proposed to characterize RB.…”

“…Several definitions have been proposed to characterize RB. In general, RB is defined by a less than 10 beats/minute rise in body temperature [128,129]. The prevalence of RB in the COVID-19 population is between 36% and 76% [128], depending on various factors from age, associated comorbidities like diabetes or use of antipyretic drugs to the release of inflammatory cytokines, increased vagal tone, direct virus effect on the myocardium and electrolyte disturbances, which are frequently described in COVID-19 pneumonia [129].…”

Сardiac arrhythmias in people who have had a coronavirus infection COVID-19: A review

“…По данным ряда исследований, у 56-60,6% больных COVID-19 наблюдается относительная брадикардия, т.е. повышение частоты сердечных сокращений (ЧСС) ниже ожидаемых величин при соответствующей температуре тела; у 34% пациентов отмечается абсолютная брадикардия (ЧСС<60 уд/мин) [19,20]. L. Jung и соавт.…”

“…(2022 г.) указывают, что относительная брадикардия может рассматриваться как дифференциально-диагностический признак COVID-19 у пациентов с лихорадочным синдромом неясного генеза [20].…”