Heart rate variability parameters indicate altered autonomic tone in subjects with COVID-19
COVID-19 is associated with long-term cardiovascular complications. Heart Rate Variability (HRV), a measure of sympathetic (SNS) and parasympathetic (PNS) control, has been shown to predict COVID-19 outcomes and correlate with disease progression but a comprehensive analysis that includes demographi...
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| description | COVID-19 is associated with long-term cardiovascular complications. Heart Rate Variability (HRV), a measure of sympathetic (SNS) and parasympathetic (PNS) control, has been shown to predict COVID-19 outcomes and correlate with disease progression but a comprehensive analysis that includes demographic influences has been lacking. The objective of this study was to determine the balance between SNS, PNS and heart rhythm regulation in hospitalized COVID-19 patients and compare it with similar measurements in healthy volunteers and individuals with cardiovascular diseases (CVD), while also investigating the effects of age, Body Mass Index (BMI), gender and race. Lead I ECG recordings were acquired from 50 COVID-19 patients, 31 healthy volunteers, and 51 individuals with cardiovascular diseases (CVD) without COVID-19. Fourteen HRV parameters were calculated, including time-domain, frequency-domain, nonlinear, and regularity metrics. The study population included a balanced demographic profile, with 55% of participants being under 65 years of age, 54% identifying as male, and 68% identifying as White. Among the COVID-19 patients, 52% had a BMI ≥ 30 compared to 29% of healthy volunteers and 33% of CVD patients. COVID-19 and CVD patients exhibited significantly reduced time-domain HRV parameters, including SDNN and RMSSD, compared to healthy volunteers (SDNN: 0.02 ± 0.02 s vs. 0.06 ± 0.03 s,
p
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| doi_str_mv | 10.1038/s41598-024-80918-w |
| format | Article |
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p
< 0.001; RMSSD: 0.02 ± 0.02 s vs. 0.05 ± 0.03 s,
p
= 0.08). In the frequency domain, both COVID-19 and CVD patients showed increased low-frequency (LF) power and lower high-frequency (HF) power compared to healthy volunteers (COVID-19 LF: 18.47 ± 18.18%, HF: 13.69 ± 25.80%; Healthy LF: 23.30 ± 11.79%, HF: 22.91 ± 21.86%,
p
< 0.01). The LF/HF ratio was similar in COVID-19 patients (1.038 ± 1.54) and healthy volunteers (1.03 ± 0.78). Nonlinear parameters such as SD1 were significantly lower in COVID-19 patients (0.04 ± 0.04 s vs. 0.08 ± 0.05 s,
p
< 0.01), indicating altered autonomic regulation. Variations in HRV were observed based on demographic factors, with younger patients, females, and non-white individuals showing more pronounced autonomic dysfunction. COVID-19 patients exhibit significant alterations in HRV, indicating autonomic dysfunction, characterized by decreased vagal tone and sympathetic dominance, similar to patients with severe cardiovascular comorbidities. Despite higher heart rates, the HRV analysis suggests COVID-19 is associated with substantial disruption in autonomic regulation, particularly in patients with specific demographic risk factors.</description><identifier>ISSN: 2045-2322</identifier><identifier>EISSN: 2045-2322</identifier><identifier>DOI: 10.1038/s41598-024-80918-w</identifier><identifier>PMID: 39730493</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>631/114/2413 ; 639/166/985 ; 692/308/53/2421 ; 692/308/575 ; Adult ; Aged ; Autonomic Nervous System - physiopathology ; Body Mass Index ; Breath tests ; Cardiovascular diseases ; Cardiovascular Diseases - etiology ; Cardiovascular Diseases - physiopathology ; Comorbidity ; COVID-19 ; COVID-19 - physiopathology ; Demography ; Dysautonomia ; EKG ; Electrocardiography ; Female ; Heart diseases ; Heart rate ; Heart Rate - physiology ; Heart rate variability ; Humanities and Social Sciences ; Humans ; Male ; Middle Aged ; multidisciplinary ; Parasympathetic nervous system ; Population studies ; Risk factors ; SARS-CoV-2 - isolation & purification ; Science ; Science (multidisciplinary) ; Sympathetic nervous system ; Vagus nerve</subject><ispartof>Scientific reports, 2024-12, Vol.14 (1), p.30774-16</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>Copyright Nature Publishing Group 2024</rights><rights>The Author(s) 2024 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0002-4235-3838</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11680776/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11680776/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,27924,27925,41120,42189,51576,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39730493$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gruionu, Gabriel</creatorcontrib><creatorcontrib>Aktaruzzaman, Md</creatorcontrib><creatorcontrib>Gupta, Anita</creatorcontrib><creatorcontrib>Nowak, Thomas V.</creatorcontrib><creatorcontrib>Ward, Matthew</creatorcontrib><creatorcontrib>Everett, Thomas H.</creatorcontrib><title>Heart rate variability parameters indicate altered autonomic tone in subjects with COVID-19</title><title>Scientific reports</title><addtitle>Sci Rep</addtitle><addtitle>Sci Rep</addtitle><description>COVID-19 is associated with long-term cardiovascular complications. Heart Rate Variability (HRV), a measure of sympathetic (SNS) and parasympathetic (PNS) control, has been shown to predict COVID-19 outcomes and correlate with disease progression but a comprehensive analysis that includes demographic influences has been lacking. The objective of this study was to determine the balance between SNS, PNS and heart rhythm regulation in hospitalized COVID-19 patients and compare it with similar measurements in healthy volunteers and individuals with cardiovascular diseases (CVD), while also investigating the effects of age, Body Mass Index (BMI), gender and race. Lead I ECG recordings were acquired from 50 COVID-19 patients, 31 healthy volunteers, and 51 individuals with cardiovascular diseases (CVD) without COVID-19. Fourteen HRV parameters were calculated, including time-domain, frequency-domain, nonlinear, and regularity metrics. The study population included a balanced demographic profile, with 55% of participants being under 65 years of age, 54% identifying as male, and 68% identifying as White. Among the COVID-19 patients, 52% had a BMI ≥ 30 compared to 29% of healthy volunteers and 33% of CVD patients. COVID-19 and CVD patients exhibited significantly reduced time-domain HRV parameters, including SDNN and RMSSD, compared to healthy volunteers (SDNN: 0.02 ± 0.02 s vs. 0.06 ± 0.03 s,
p
< 0.001; RMSSD: 0.02 ± 0.02 s vs. 0.05 ± 0.03 s,
p
= 0.08). In the frequency domain, both COVID-19 and CVD patients showed increased low-frequency (LF) power and lower high-frequency (HF) power compared to healthy volunteers (COVID-19 LF: 18.47 ± 18.18%, HF: 13.69 ± 25.80%; Healthy LF: 23.30 ± 11.79%, HF: 22.91 ± 21.86%,
p
< 0.01). The LF/HF ratio was similar in COVID-19 patients (1.038 ± 1.54) and healthy volunteers (1.03 ± 0.78). Nonlinear parameters such as SD1 were significantly lower in COVID-19 patients (0.04 ± 0.04 s vs. 0.08 ± 0.05 s,
p
< 0.01), indicating altered autonomic regulation. Variations in HRV were observed based on demographic factors, with younger patients, females, and non-white individuals showing more pronounced autonomic dysfunction. COVID-19 patients exhibit significant alterations in HRV, indicating autonomic dysfunction, characterized by decreased vagal tone and sympathetic dominance, similar to patients with severe cardiovascular comorbidities. Despite higher heart rates, the HRV analysis suggests COVID-19 is associated with substantial disruption in autonomic regulation, particularly in patients with specific demographic risk factors.</description><subject>631/114/2413</subject><subject>639/166/985</subject><subject>692/308/53/2421</subject><subject>692/308/575</subject><subject>Adult</subject><subject>Aged</subject><subject>Autonomic Nervous System - physiopathology</subject><subject>Body Mass Index</subject><subject>Breath tests</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Cardiovascular Diseases - physiopathology</subject><subject>Comorbidity</subject><subject>COVID-19</subject><subject>COVID-19 - physiopathology</subject><subject>Demography</subject><subject>Dysautonomia</subject><subject>EKG</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Heart diseases</subject><subject>Heart rate</subject><subject>Heart Rate - physiology</subject><subject>Heart rate variability</subject><subject>Humanities and Social Sciences</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>multidisciplinary</subject><subject>Parasympathetic nervous system</subject><subject>Population studies</subject><subject>Risk factors</subject><subject>SARS-CoV-2 - isolation & purification</subject><subject>Science</subject><subject>Science (multidisciplinary)</subject><subject>Sympathetic nervous system</subject><subject>Vagus nerve</subject><issn>2045-2322</issn><issn>2045-2322</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNpdUstuFDEQHCEQiZL8AAc0EhcuQ_waP04IbYCsFCkXkgsHq8fu2Xg1j8WeySp_j3c3kIcvbbtK5Wp3FcUHSr5QwvV5ErQ2uiJMVJoYqqvtm-KYEVFXjDP29tn-qDhLaU3yqpkR1LwvjrhRnAjDj4vflwhxKiNMWN5DDNCELkwP5QYi9DhhTGUYfHA7HLp8Rl_CPI3D2AdX5ooZL9PcrNFNqdyG6a5cXN8uLypqTot3LXQJzx7rSXHz4_uvxWV1df1zufh2VXlWk23FHPeSe1VLDRKd1EYrxsAJpM5QRYSjnrJWQ-Nr5YVSqKX0njdM1ga05CfF8qDrR1jbTQw9xAc7QrD7izGubO4xuA4tgBYAIIjnVIiaA20alC1qhFY0LctaXw9am7np0TscpgjdC9GXyBDu7Gq8t5RKTZTaufn8qBDHPzOmyfYhOew6GHCck80Pm12vWmXqp1fU9TjHIf_VniXzvIzIrI_PLf338m-ImcAPhJShYYXxSYYSu0uLPaTF5rTYfVrslv8FBSSwdQ</recordid><startdate>20241228</startdate><enddate>20241228</enddate><creator>Gruionu, Gabriel</creator><creator>Aktaruzzaman, Md</creator><creator>Gupta, Anita</creator><creator>Nowak, Thomas V.</creator><creator>Ward, Matthew</creator><creator>Everett, Thomas H.</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><general>Nature Portfolio</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>88I</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-4235-3838</orcidid></search><sort><creationdate>20241228</creationdate><title>Heart rate variability parameters indicate altered autonomic tone in subjects with COVID-19</title><author>Gruionu, Gabriel ; Aktaruzzaman, Md ; Gupta, Anita ; Nowak, Thomas V. ; Ward, Matthew ; Everett, Thomas H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-d250w-2c3d63d7568a6ec6898722ac4e1c91704c1d12f8abd57d477e866dd3b2659a863</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>631/114/2413</topic><topic>639/166/985</topic><topic>692/308/53/2421</topic><topic>692/308/575</topic><topic>Adult</topic><topic>Aged</topic><topic>Autonomic Nervous System - physiopathology</topic><topic>Body Mass Index</topic><topic>Breath tests</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular Diseases - etiology</topic><topic>Cardiovascular Diseases - physiopathology</topic><topic>Comorbidity</topic><topic>COVID-19</topic><topic>COVID-19 - physiopathology</topic><topic>Demography</topic><topic>Dysautonomia</topic><topic>EKG</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Heart diseases</topic><topic>Heart rate</topic><topic>Heart Rate - physiology</topic><topic>Heart rate variability</topic><topic>Humanities and Social Sciences</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>multidisciplinary</topic><topic>Parasympathetic nervous system</topic><topic>Population studies</topic><topic>Risk factors</topic><topic>SARS-CoV-2 - isolation & purification</topic><topic>Science</topic><topic>Science (multidisciplinary)</topic><topic>Sympathetic nervous system</topic><topic>Vagus nerve</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gruionu, Gabriel</creatorcontrib><creatorcontrib>Aktaruzzaman, Md</creatorcontrib><creatorcontrib>Gupta, Anita</creatorcontrib><creatorcontrib>Nowak, Thomas V.</creatorcontrib><creatorcontrib>Ward, Matthew</creatorcontrib><creatorcontrib>Everett, Thomas H.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Scientific reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gruionu, Gabriel</au><au>Aktaruzzaman, Md</au><au>Gupta, Anita</au><au>Nowak, Thomas V.</au><au>Ward, Matthew</au><au>Everett, Thomas H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Heart rate variability parameters indicate altered autonomic tone in subjects with COVID-19</atitle><jtitle>Scientific reports</jtitle><stitle>Sci Rep</stitle><addtitle>Sci Rep</addtitle><date>2024-12-28</date><risdate>2024</risdate><volume>14</volume><issue>1</issue><spage>30774</spage><epage>16</epage><pages>30774-16</pages><issn>2045-2322</issn><eissn>2045-2322</eissn><abstract>COVID-19 is associated with long-term cardiovascular complications. Heart Rate Variability (HRV), a measure of sympathetic (SNS) and parasympathetic (PNS) control, has been shown to predict COVID-19 outcomes and correlate with disease progression but a comprehensive analysis that includes demographic influences has been lacking. The objective of this study was to determine the balance between SNS, PNS and heart rhythm regulation in hospitalized COVID-19 patients and compare it with similar measurements in healthy volunteers and individuals with cardiovascular diseases (CVD), while also investigating the effects of age, Body Mass Index (BMI), gender and race. Lead I ECG recordings were acquired from 50 COVID-19 patients, 31 healthy volunteers, and 51 individuals with cardiovascular diseases (CVD) without COVID-19. Fourteen HRV parameters were calculated, including time-domain, frequency-domain, nonlinear, and regularity metrics. The study population included a balanced demographic profile, with 55% of participants being under 65 years of age, 54% identifying as male, and 68% identifying as White. Among the COVID-19 patients, 52% had a BMI ≥ 30 compared to 29% of healthy volunteers and 33% of CVD patients. COVID-19 and CVD patients exhibited significantly reduced time-domain HRV parameters, including SDNN and RMSSD, compared to healthy volunteers (SDNN: 0.02 ± 0.02 s vs. 0.06 ± 0.03 s,
p
< 0.001; RMSSD: 0.02 ± 0.02 s vs. 0.05 ± 0.03 s,
p
= 0.08). In the frequency domain, both COVID-19 and CVD patients showed increased low-frequency (LF) power and lower high-frequency (HF) power compared to healthy volunteers (COVID-19 LF: 18.47 ± 18.18%, HF: 13.69 ± 25.80%; Healthy LF: 23.30 ± 11.79%, HF: 22.91 ± 21.86%,
p
< 0.01). The LF/HF ratio was similar in COVID-19 patients (1.038 ± 1.54) and healthy volunteers (1.03 ± 0.78). Nonlinear parameters such as SD1 were significantly lower in COVID-19 patients (0.04 ± 0.04 s vs. 0.08 ± 0.05 s,
p
< 0.01), indicating altered autonomic regulation. Variations in HRV were observed based on demographic factors, with younger patients, females, and non-white individuals showing more pronounced autonomic dysfunction. COVID-19 patients exhibit significant alterations in HRV, indicating autonomic dysfunction, characterized by decreased vagal tone and sympathetic dominance, similar to patients with severe cardiovascular comorbidities. Despite higher heart rates, the HRV analysis suggests COVID-19 is associated with substantial disruption in autonomic regulation, particularly in patients with specific demographic risk factors.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>39730493</pmid><doi>10.1038/s41598-024-80918-w</doi><tpages>16</tpages><orcidid>https://orcid.org/0000-0002-4235-3838</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | 631/114/2413 639/166/985 692/308/53/2421 692/308/575 Adult Aged Autonomic Nervous System - physiopathology Body Mass Index Breath tests Cardiovascular diseases Cardiovascular Diseases - etiology Cardiovascular Diseases - physiopathology Comorbidity COVID-19 COVID-19 - physiopathology Demography Dysautonomia EKG Electrocardiography Female Heart diseases Heart rate Heart Rate - physiology Heart rate variability Humanities and Social Sciences Humans Male Middle Aged multidisciplinary Parasympathetic nervous system Population studies Risk factors SARS-CoV-2 - isolation & purification Science Science (multidisciplinary) Sympathetic nervous system Vagus nerve |
| title | Heart rate variability parameters indicate altered autonomic tone in subjects with COVID-19 |
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