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. 2023 Feb 23;23(5):2473.
doi: 10.3390/s23052473.

Association of Heart Rate Variability with Pulmonary Function Impairment and Symptomatology Post-COVID-19 Hospitalization

Estelle A M C Adang  1 , Maud T A Strous  2 , Joop P van den Bergh  2   3 , Debbie Gach  3   4 , Vivian E M van Kampen  5 , Roel E P van Zeeland  5 , Dennis G Barten  1 , Frits H M van Osch  3   4   6
Affiliations

Association of Heart Rate Variability with Pulmonary Function Impairment and Symptomatology Post-COVID-19 Hospitalization

Estelle A M C Adang et al. Sensors (Basel). .

Abstract

The persistence of symptoms beyond three months after COVID-19 infection, often referred to as post-COVID-19 condition (PCC), is commonly experienced. It is hypothesized that PCC results from autonomic dysfunction with decreased vagal nerve activity, which can be indexed by low heart rate variability (HRV). The aim of this study was to assess the association of HRV upon admission with pulmonary function impairment and the number of reported symptoms beyond three months after initial hospitalization for COVID-19 between February and December 2020. Follow-up took place three to five months after discharge and included pulmonary function tests and the assessment of persistent symptoms. HRV analysis was performed on one 10 s electrocardiogram obtained upon admission. Analyses were performed using multivariable and multinomial logistic regression models. Among 171 patients who received follow-up, and with an electrocardiogram at admission, decreased diffusion capacity of the lung for carbon monoxide (DLCO) (41%) was most frequently found. After a median of 119 days (IQR 101-141), 81% of the participants reported at least one symptom. HRV was not associated with pulmonary function impairment or persistent symptoms three to five months after hospitalization for COVID-19.

Keywords: COVID-19; autonomic dysfunction; heart rate variability; long COVID; lung function; post-COVID-19 condition; symptomatology; vagal nerve activity.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Study flow chart.
Figure 2
Figure 2
Symptom experience between 3 and 5 months after hospitalization for COVID-19 according to heart rate variability. Note: SDNN = standard deviation of normal to normal heartbeat intervals; RMSDD = root mean square of successive differences between adjacent heartbeats. Both SDNN and RMSSD cut-offs are in msec.
See this image and copyright information in PMC

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