Cardiac Autonomic Dysfunction Measured as Reduced Heart Rate Variability, in the Intermediate Post-Covid State in Men

• Published in: Current Medical Issues Vol. 22; no. 1; pp. 14 - 20
• Main Authors: Senthamizselvan, R., Tharion, Elizabeth, George, Krupa, Zachariah, Anand, Rani, Jansi, Rebekah, Grace, Christudoss, Pamela
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer - Medknow 2024; Medknow Publications and Media Pvt. Ltd; Wolters Kluwer Medknow Publications
• Edition: 2
• Subjects: autonomic dysfunction; Autonomic neuropathies; cardiac autonomic; Causes of; coronavirus disease 2019; Coronaviruses; Corticosteroids; Diagnosis; Dysautonomia; Health aspects; Heart beat; Heart diseases; heart rate variability; Medical research; Medicine, Experimental; Men; Original Article; post-coronavirus disease; Psychological aspects; Risk factors; stress; Stress (Psychology); India; Autonomic dysfunction; stress; cardiac autonomic; post-coronavirus disease; heart rate variability; coronavirus disease 2019
• ISSN: 0973-4651; 2666-4054
• DOI: 10.4103/cmi.cmi_71_23

Abstract Background: A critical illness such as severe coronavirus disease 2019 (COVID-19) activates autonomic, endocrine, and emotional stress responses. Whether the manifestations of excessive stress experience persist beyond full recovery into the intermediate post-COVID period (3-6 months after recovery) is not known and was the question we addressed in the current study. Methods: An analytical observational cross-sectional study compared the heart rate variability (HRV), 8 AM serum cortisol concentration, and the Depression, Anxiety, and Stress Scale-21 (DASS-21) scores between COVID-19 recovered participants and their age-matched control subjects (21 male participants, 30-70 years of age, in each group). Results: The median (Q1-Q3) of low frequency (LF), high frequency (HF), and total powers of HRV was significantly reduced in those who recovered from severe COVID-19, compared to control subjects (respectively LF power: 410.871 [245.10-861.94], 947.57 [536.11-1778.55], P = 0.011; HF power: 192.916 [87.66-564.43], 705.18 [248.67-1192.19] P = 0.013; Total power: 646.33 [308.72-1518.28], 1613.33 [956.14-4022.55] P = 0.015, Mann-Whitney U-test). Serum cortisol and DASS-21 scores were not different from the control group. Conclusions: Impaired cardiac autonomic function, evidenced by reduced HRV, was observed in the intermediate period following recovery from severe COVID-19. However, psychological stress and elevated serum cortisol were not noted. Our result that exposes the effect of COVID-19 on cardiac autonomic responsiveness is important as diminished HRV increases the vulnerability of COVID-19 survivors to diseases. These findings may also suggest a focus of therapy in them, as specific interventions are known to improve HRV and cardiac autonomic functioning.