Altered Heart Rate Variability Early in ICU Admission Differentiates Critically Ill Coronavirus Disease 2019 and All-Cause Sepsis Patients

Kamaleswaran, Rishikesan; Sadan, Ofer; Kandiah, Prem; Li, Qiao; Coopersmith, Craig M.; Buchman, Timothy G.

doi:10.1097/cce.0000000000000570

Cited by 14 publications

(44 citation statements)

References 45 publications

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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%

“…Finally, 22 studies were included in this systematic review [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48]94,95]. Details regarding the selection process are available in the PRISMA diagram (Figure 1).…”

Section: Study Selectionmentioning

confidence: 99%

“…Reports assessed as eligible-Refs. [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48]. Reports added from other sources-Refs.…”

Section: Study Selectionmentioning

confidence: 99%

“…Studies included in the systematic review-Refs. [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48]94,95]. Abbreviations: COVID-19, Coronavirus disease 2019.…”

Section: Study Selectionmentioning

confidence: 99%

“…All the studies included in this review were observational: five with a cross-sectional design [31,36,40,46,47]; nine retrospective studies, including four case-control studies [37,41,44,94], two cohort studies [30,43], and three pre-post studies [33,35,95]; eight prospective studies that included seven cohort studies [29,32,34,38,39,42,45] and one pre-post study [48].…”

Section: Study Characteristicsmentioning

confidence: 99%

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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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Section: Study Selectionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

“…Reports assessed as eligible-Refs. [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48]. Reports added from other sources-Refs.…”

Section: Study Selectionmentioning

confidence: 99%

“…Studies included in the systematic review-Refs. [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48]94,95]. Abbreviations: COVID-19, Coronavirus disease 2019.…”

Section: Study Selectionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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

Scala

Rizzo

Bellavia

et al. 2022

JCM

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Cardiac deceleration capacity is associated with severity of inflammation in COVID-19

Hoppe,

Strüven,

Brunner

et al. 2023

Infection

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Purpose In this pilot study, we investigated the cardiac autonomic activity of coronavirus disease 2019 (COVID-19)-infected hospitalized patients. COVID-19 is characterized by cough, fever, and dyspnea, which in some severe cases can lead to hypoxia, respiratory failure, and shock. Since breathing disorders and pulmonary diseases are tightly linked to autonomic dysfunction, we analyzed the cardiac autonomic activity by measuring the deceleration capacity (DC) in COVID-19 patients. Methods In 14 adults (4 men and 10 women) with a median age of 63.5 years and positive for SARS-CoV-2 by polymerase chain reaction (PCR) with severe symptoms requiring hospital treatment, a high-resolution digital 30 min electrocardiogram (ECG) in Frank leads configuration was performed in a resting supine position within the first 48 h after hospital admission. DC was assessed using validated software and associated with several markers of inflammation and clinical course. Results The study revealed a significant association between reduced DC (≤ 2.5 ms) and older age (74 years) in COVID-19 patients, compared to those with a higher DC > 2.5 ms (56.5 years). However, the duration of hospitalization was similar for both groups. There was a nonsignificant trend towards a higher maximum viral load in patients with reduced DC. Further, patients with a DC ≤ 2.5 ms showed higher levels of inflammatory markers such as C-reactive protein (CRP) and procalcitonin (PCT), as well as leukocytosis, compared to patients with a DC > 2.5 ms. Also, the COVID-19-severity marker ferritin was significantly elevated in patients with lower DC. Other markers associated with COVID-19, such as lactate dehydrogenase (LDH) and creatine kinase (CK), exhibited comparable levels in both groups. Conclusions Reduced DC (≤ 2.5 ms) was significantly associated with older age, increased inflammatory markers, and elevated ferritin in patients with COVID-19. These findings suggest that DC might serve as a valuable indicator for predicting the risk of severe inflammation in COVID-19 and possibly complications associated with this disease, such as heart failure. Further studies are needed to confirm these observations and clarify the clinical significance of DC in COVID-19 and other infectious diseases.

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