Impact of COVID-19 on cardiac autonomic function in healthy young adults: potential role of symptomatology and time since diagnosis

Skow, Rachel J.; Garza, Nicole A.; Nandadeva, Damsara; Stephens, Brandi Y.; Wright, Alexis N; Grotle, Ann-Katrin; Young, Benjamin E.; Fadel, Paul J.

doi:10.1152/ajpheart.00520.2022

Cited by 14 publications

(7 citation statements)

References 23 publications

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“…However, these previous reports found some conflicting differences in the HRV indices reflective of parasympathetic tone. Stute and colleagues reported an increase in parasympathetic tone while the most recent report by Skow and colleagues showed that HRV indices were unchanged compared to otherwise healthy individuals without a COVID-19 diagnosis and the parasympathetic and global variability improved in the time since the diagnosis ( Stute et al, 2021 ; Skow et al, 2022 ). Consistent with the latter, in the present study, there were no appreciable differences in resting parasympathetic tone, assessed via HRV indices (e.g., RMSSD and HF power).…”

Section: Discussionmentioning

confidence: 99%

“…However, during viral infections, increased circulating inflammatory cytokines are believed to drive this increase in sympathetic nerve activity, while the vagus nerve acts as a neuro-immuno-modulator pathway between the brain and peripheral inflammation. The indices of HRV have been used to assess sympathetic and parasympathetic function in young adults during the weeks following a SARS-CoV-2 infection ( Stute et al, 2021 ; Freire et al, 2022 ; Skow et al, 2022 ). However, these previous reports found some conflicting differences in the HRV indices reflective of parasympathetic tone.…”

Section: Discussionmentioning

confidence: 99%

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Autonomic and vascular function testing in collegiate athletes following SARS-CoV-2 infection: an exploratory study

et al. 2023

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Introduction: Recent studies suggest that SARS-CoV-2 infection alters autonomic and vascular function in young, otherwise healthy, adults. However, whether these alterations exist in young competitive athletes remains unknown. This study aimed to assess the effects of COVID-19 on cardiac autonomic control and vascular function in collegiate athletes who tested positive for COVID-19, acknowledging the limitations imposed by the early stages of the pandemic.Methods: Sixteen collegiate athletes from various sports underwent a battery of commonly used autonomic and vascular function tests (23 ± 9, range: 12–44 days post-infection). Additionally, data from 26 healthy control participants were included.Results: In response to the Valsalva maneuver, nine athletes had a reduced early phase II blood pressure response and/or reduced Valsalva ratio. A depressed respiratory sinus arrhythmia amplitude was observed in three athletes. Three athletes became presyncopal during standing and did not complete the 10-min orthostatic challenge. Brachial artery flow-mediated dilation, when allometrically scaled to account for differences in baseline diameter, was not different between athletes and controls (10.0% ± 3.5% vs. 7.1% ± 2.4%, p = 0.058). Additionally, no differences were observed between groups when FMD responses were normalized by shear rate (athletes: 0.055% ± 0.026%/s-1, controls: 0.068% ± 0.049%/s-1, p = 0.40).Discussion: Few atypical and borderline responses to autonomic function tests were observed in athletes following an acute SARS-CoV-2 infection. The most meaningful autonomic abnormality being the failure of three athletes to complete a 10-min orthostatic challenge. These findings suggest that some athletes may develop mild alterations in autonomic function in the weeks after developing COVID-19, while vascular function is not significantly impaired.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Autonomic and vascular function testing in collegiate athletes following SARS-CoV-2 infection: an exploratory study

et al. 2023

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“…However, in the patients with PCC, baroreflex failure was not correlated with fatigue in contrast to the ME/CFS patients. It should be noted that there are conflicting data on the presence of baroreflex failure in PCC in the literature [ 31 ]. The negative correlation of BRSup with age in the HCs (but not in the ME/CFS patients where it was correlated with the severity of fatigue) provides more evidence for the hypothesis of the accelerated aging of the autonomic nervous system in ME/CFS.…”

Section: Discussionmentioning

confidence: 99%

Similar Patterns of Dysautonomia in Myalgic Encephalomyelitis/Chronic Fatigue and Post-COVID-19 Syndromes

Ryabkova,

Rubinskiy,

Marchenko

et al. 2024

Pathophysiology

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Background: There is a considerable overlap between the clinical presentation of post-COVID-19 condition (PCC) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Many of their common symptoms can be linked to dysregulation of the autonomic nervous system (dysautonomia). This study aimed to objectively assess autonomic function in a general group of patients with PCC and in a group of patients with ME/CFS whose disease was not related to COVID-19. We hypothesize that the similarity in the chronic symptoms of patients with PCC and ME/CFS extends to objective autonomic nervous system abnormalities. Methods: Synchronous recordings of an electrocardiogram and continuous dynamics of blood pressure in the digital artery using the Penaz method were obtained using the spiroarteriocardiorhythmography method in 34 patients diagnosed with ME/CFS, in whom the onset of the disease was not associated with COVID-19, 29 patients meeting the PCC definition and 32 healthy controls. Heart rate variability (HRV) and systolic and diastolic blood pressure variability (BPV) were assessed at rest and in tests with fixed respiratory rates. Indicators of baroreflex regulation (baroreflex effectiveness index and baroreflex sensitivity) were additionally determined at rest. Results: The total power and power of low-frequency and high-frequency of RR interval variability at rest as well as baroreflex sensitivity were significantly lower both in PCC and ME/CFS patients compared to healthy controls. Several diagnostic prediction models for ME/CFS were developed based on HRV parameters. During slow breathing, the HRV parameters returned to normal in PCC but not in ME/CFS patients. The correlation analysis revealed a close relationship of HRV, BPV parameters and baroreflex sensitivity with fatigue, but not with HADS depressive/anxiety symptoms in the ME/CFS and PCC patients. Conclusions: A similar pattern of HRV and baroreflex failure with signs of a pathological acceleration of age-dependent dysautonomia was identified in the ME/CFS and PCC patients. The clinical, diagnostic and therapeutic implications of these findings are discussed, in light of previously described relationships between inflammation, vascular pathology, atherosclerotic cardiovascular disease and autonomic dysfunction.

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“…In other words, the magnitude of RMSSD enhanced by aHRSR enhanced BRS, suggesting that it may be involved in BP in the short‐ and long‐term. Based on this, it is suggested that stimulation of aHRSR both improves the stability and homeostasis of the autonomic nervous system, and induces changes in the human body through additional physiological stimulation (Savabi et al, 2020 ; Skow et al, 2022 ; Swenne, 2013 ). This shows various possibilities for application, such as healthcare methods and biofeedback methods that individuals can use (Kim et al, 2023 ).…”

Section: Discussionmentioning

confidence: 99%

Sound stimulation using the individual's heart rate to improve the stability and homeostasis of the autonomic nervous system

Kim,

Lee

et al. 2023

Physiological Reports

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ObjectivesIn this study, we explain the role of enhancing the stability and homeostasis of the autonomic nervous system (ANS) by proposing the average heart rate sound resonance (aHRSR), a sound stimulation to prevent imbalance of ANS due to dynamic movement. The effect of aHRSR on ANS was analyzed through the time and frequency domain of heart rate variability (HRV) using the photoplethysmogram data (PPG) of 22 participants (DUIRB‐202109‐12).MethodWhen the subjects performed dynamic movements that could cause changes in the ANS, HRV indicators using PPG data for 5 min before and after the movements were analyzed according to the presence or absence of aHRSR. The standard deviation of the NN intervals (SDNN), the square root of the mean squared differences of the NN intervals (RMSSD), low‐frequency band (LF), and high‐frequency band (HF), which represent sympathetic and parasympathetic nerve activity, were used as indicators, where SNDD and LF represent total ANS and sympathetic activity, while RMSSD and HF represent parasympathetic activity.ResultsAs the effects of aHRSR on dynamic movement, the recovery time of RR interval was advanced by about 15 s, SDNN increased from ([44.16 ± 13.11] to [47.85 ± 15.16]) ms, and RMSSD increased from ([23.73 ± 9.95] to [31.89 ± 12.48]) ms (p < 0.05), increasing the stability of the ANS and reducing instability. The effect of homeostasis of the ANS according to aHRSR is also shown in reducing the change rate of LF from (−13.83 to −8.83) %, and the rate of change of HF from (10.59 to 3.27) %.ConclusionsThese results suggest that aHRSR can affect the cardiovascular system by assisting physiological movements that occur during dynamic movement.

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Impact of COVID-19 on cardiac autonomic function in healthy young adults: potential role of symptomatology and time since diagnosis

Cited by 14 publications

References 23 publications

Autonomic and vascular function testing in collegiate athletes following SARS-CoV-2 infection: an exploratory study

Autonomic and vascular function testing in collegiate athletes following SARS-CoV-2 infection: an exploratory study

Similar Patterns of Dysautonomia in Myalgic Encephalomyelitis/Chronic Fatigue and Post-COVID-19 Syndromes

Sound stimulation using the individual's heart rate to improve the stability and homeostasis of the autonomic nervous system

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