Wireless Heart Rate Variability in Assessing Community COVID-19

Drury, Robert L.; Jarczok, Marc N.; Owens, Andrew; Thayer, Julian F.

doi:10.3389/fnins.2021.564159

Cited by 17 publications

(18 citation statements)

References 45 publications

(50 reference statements)

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“…Major strides are being made in monitoring autonomic function using wearable devices like the Apple Watch or Fitbit device, as well as in automatically transferring electrocardiographic and heart rate variability data electronically to central databases, providing information to clinicians and investigators (39,40). Indeed, such devices have been used to look for early warning signs of new COVID-19 infection, and it has been shown that increased heart rate variability is correlated with health benefits across many disease states, including inflammatory conditions such as COVID-19 and ME/CFS (40). However, many patients do not yet have such devices.…”

Section: Discussionmentioning

confidence: 99%

Orthostatic Challenge Causes Distinctive Symptomatic, Hemodynamic and Cognitive Responses in Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

et al. 2022

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BackgroundSome patients with acute COVID-19 are left with persistent, debilitating fatigue, cognitive impairment (“brain fog”), orthostatic intolerance (OI) and other symptoms (“Long COVID”). Many of the symptoms are like those of other post-infectious fatigue syndromes and may meet criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Common diagnostic laboratory tests are often unrevealing.MethodsWe evaluated whether a simple, standardized, office-based test of OI, the 10-min NASA Lean Test (NLT), would aggravate symptoms and produce objective hemodynamic and cognitive abnormalities, the latter being evaluated by a simple smart phone-based app.ParticipantsPeople with Long COVID (N = 42), ME/CFS (N = 26) and healthy control subjects (N = 20) were studied just before, during, immediately after, 2 and 7 days following completion of the NLT.ResultsThe NLT provoked a worsening of symptoms in the two patient groups but not in healthy control subjects, and the severity of all symptoms was similar and significantly worse in the two patient groups than in the control subjects (p < 0.001). In the two patient groups, particularly those with Long COVID, the NLT provoked a marked and progressive narrowing in the pulse pressure. All three cognitive measures of reaction time worsened in the two patient groups immediately following the NLT, compared to the healthy control subjects, particularly in the Procedural Reaction Time (p < 0.01).ConclusionsA test of orthostatic stress easily performed in an office setting reveals different symptomatic, hemodynamic and cognitive abnormalities in people with Long COVID and ME/CFS, compared to healthy control subjects. Thus, an orthostatic challenge easily performed in an office setting, and the use of a smart phone app to assess cognition, can provide objective confirmation of the orthostatic intolerance and brain fog reported by patients with Long COVID and ME/CFS.

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Section: Discussionmentioning

confidence: 99%

Orthostatic Challenge Causes Distinctive Symptomatic, Hemodynamic and Cognitive Responses in Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

et al. 2022

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“…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%

Autonomic Dysfunction during Acute SARS-CoV-2 Infection: A Systematic Review

Scala

Rizzo

Bellavia

et al. 2022

JCM

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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.

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“…We also observed that patients with a heart rate >110 bpm were more likely to be intubated, congruent with previous reports that abnormal heart rate is observed in 6 to 7% of hospitalized COVID-19 patients [ 13 ]. Heart rate variability is a key marker of inflammatory activity and immune system activation [ 14 ]. Similarly, patients who required CPAP at admission were more likely to progress to intubation.…”

Section: Discussionmentioning

confidence: 99%