Autonomic heart rate modulation in patients with coronavirus disease 2019 in mechanical ventilation

Abstract

BACKGROUND: Patients with coronavirus disease 2019 on automatic mechanical ventilation have greater heart rate modulation with greater parasympathetic modulation. OBJECTIVE: To analyze the autonomic modulation of heart rate in critically ill patients with coronavirus disease 2019 on invasive mechanical ventilation. METHODS: A cross-section study was carried out with 36 individuals divided into two groups. The control group included patients of both genders, in orotracheal intubation with invasive mechanical ventilation under controlled assisted mode, hospitalized in the intensive care unit for another 24 h. In the non-COVID group, patients diagnosed with coronavirus disease 2019 in the same condition mentioned in the control group. RESULTS: There was a significant increase in heart rate variability (standard deviation of all normal RR intervals recorded at an interval of time; p=0.001; triangular interpolation histogram of RR intervals; p=0.048; and SD2; p=0.014) in the coronavirus disease group compared to the non-COVID group. Successively, the parameters that demonstrate parasympathetic modulation are shown to be higher in the group of patients with coronavirus disease 2019 (root mean square of the square of differences between adjacent normal RR intervals in an interval of time; p<0.001; pNN50; p<0.001; SD1; p=0.002; and high frequency; p=0.022). CONCLUSIONS: There was a greater autonomic modulation of heart rate with a greater parasympathetic modulation in patients with coronavirus disease 2019 on mechanical ventilation.

Heart Rate Variability Parameters Were Not Associated With 30-Day All-Cause Mortality in Intensive Care Unit Patients With or Without Atrial Fibrillation: A Retrospective Study of the Mimic-Iv Database

“…In contrast to our study, a study of patients with COVID-19 infection and mechanical ventilation reported a greater parasympathetic modulation of heart rate, as evidenced by higher levels of pNN50 and rMSSD compared with patients without COVID-19 infection, and the author concluded that the monitoring of parasympathetic tone in COVID-19 infection may be a predictive marker of disease progression (39). In another study of patients with severe head injury, increased parasympathetic tone assessed by HRV on the day after trauma was predictive of brain death, whereas a decreased parasympathetic tone in the awakening period was associated with worse clinical recovery, suggesting a dynamic change in autonomic nervous tone in these patients (40).…”

NN50 and pNN50, two time-domain heart rate variability parameters were associated with 30-day all-cause mortality in patients admitted to intensive care unit: A Retrospective Study of the MIMIC-IV Database

“…The clinical implications of increased parasympathetic tone in intensive care medicine have been less reported in the literature. A study of patients with COVID-19 infection and mechanical ventilation reported a greater parasympathetic modulation of heart rate, as evidenced by higher levels of pNN50 and rMSSD compared with patients without COVID-19 infection, and the author concluded that the monitoring of parasympathetic tone in COVID-19 infection may be a predictive marker of disease progression [28]. In another study of patients with severe head injury, increased parasympathetic tone assessed by HRV on the day after trauma was predictive of brain death, whereas a decreased parasympathetic tone in the awakening period was associated with worse clinical recovery, suggesting a dynamic change in autonomic nervous tone in these patients[29].…”