The contribution of psychological distress to resting palpitations in patients recovering from severe coronavirus disease 2019

Abstract

Background: Increasing numbers of patients have recovered from severe coronavirus disease 2019 in Wuhan, China. This study aimed to evaluate the association of psychological distress with resting palpitations in those recovered patients. Methods: In this prospective cohort study, consecutive patients who recovered from severe COVID-19 and complained of resting palpitations were included. Dynamic electrocardiogram (ECG) was continuously monitored for 2 hours while patients were at rest. A survey using palpitation frequency scale and the Hospital Anxiety and Depression Scale (HADS) was administrated to all participants. Results: Of the 289 consecutive patients recovering from severe COVID-19, 24 patients (8.3%) suffered resting palpitations symptoms, and 22 patients were finally included. Dynamic ECG monitoring showed that 18 (81.8%) patients had tachyarrhythmias, of which, the most common was sinus tachycardia (17/22, 77.3%). However, patients with sinus tachycardia showed a similar frequency of palpitations episodes compared to those without sinus tachycardia. Anxiety (68.2%) and depression (59.1%) were prevalent among these recovered patients. Patients with anxiety or depression symptoms were respectively associated with a higher frequency of palpitations episodes than those without. In addition, both HADS-anxiety score (r =0.609, P<0.01) and HADS-depression score (r =0.516, P=0.01) were positively related to the frequency of palpitations episodes, respectively. Conclusion: Symptom of resting palpitations, manifested mainly by sinus tachycardia, is not uncommon in patients recovering from severe COVID-19. Psychological distress (anxiety and depression) may be responsible, at least in part, for the resting palpitations symptoms.Recently, several studies have focused on the mental health in COVID-19 patients. The results found that a majority of the infected patients experienced various mental disturbances during hospitalization and even