Increased Autonomic Reactivity and Mental Health Difficulties in COVID-19 Survivors: Implications for Medical Providers

Abstract

BackgroundBecause there is a relationship between mental health (MH) and medical adversity and autonomic dysregulation, we hypothesized that individuals infected with COVID-19 would report greater current autonomic reactivity and more MH difficulties (emotional distress, mindfulness difficulties, and posttraumatic stress). We also hypothesized that individuals diagnosed with COVID-19 who are experiencing difficulties related to their prior adversity and those providing medical care to COVID-19 patients would be more negatively impacted due to their increased stress and infection rates.MethodUS participants (N = 1,638; 61% female; Age M = 46.80) completed online self-report measures of prior adversity, current autonomic reactivity and current MH difficulties, and COVID-19 diagnosis history. Participants diagnosed with COVID-19 (n = 98) were more likely to be younger and providing medical care to COVID-19 patients.ResultsIndividuals diagnosed with COVID-19 reported increased current autonomic reactivity, being more negatively impacted by their prior MH/medical adversities, and currently experiencing more MH difficulties with an increased likelihood of clinically-significant PTSD and depression (p < 0.01 – p < 0.001). Current autonomic reactivity mediated 58.9% to 85.2% of the relationship between prior adversity and current MH difficulties; and COVID-19 diagnosis moderated and enhanced the effect of prior adversity on current autonomic reactivity (p < 0.01). Being a medical provider was associated with increased current autonomic reactivity (p < 0.01), while moderating and enhancing the relationship between current autonomic reactivity and emotional distress and posttraumatic stress symptoms (p < 0.05). Combining COVID-19 diagnosis with being a medical provider increased likelihood of clinically-significant PTSD and depression (p < 0.01).ConclusionIndividuals diagnosed with COVID-19, particularly medical providers, have increased current autonomic reactivity that is associated with their prior adversities and current MH difficulties.

Heart Rate Variability: A Personal Journey

“…An important tennent of Polyvagal Theory is the role of autonomic state as an intervening variable and placing indices of autonomic state (e.g., RSA, vagal efficiency) as the'O' in a more explanatory S-O-R model. Our research continues to document the important mediating influence of autonomic state on clinical outcome (see Dale et al, 2022aDale et al, , 2022bKolacz et al, 2020), whether the metric used is autonomic (e.g., RSA, vagal efficiency) or subjective reports of autonomic state (e.g., Cabrera et al, 2017).…”

“…In a clinical study using a posture challenge protocol, it was possible to detect a subset of patients in a pediatric gastroenterology clinic with joint hypermobility syndrome (Kolacz et al, 2021 ). In another study, an exercise bike challenge was used in a study with college students and vagal efficiency distinguished participants with and without a maltreatment history (see Dale et al, 2022a ). On a clinical level, it appears that vagal efficiency may provide an objective metric related to the clinical features associated with a diagnosis of dysautonomia.…”

Effects of COVID-19 stress, proximity, and adverse childhood experiences on healthcare workers’ mental health

“…The Adverse and Traumatic Experiences Scale (Dale et al, 2020(Dale et al, , 2022Kolacz et al, 2020) was administered to assess adverse childhood experiences (ACEs). This is a 30-question instrument that asks about adversity and traumatic experiences, and covers both childhood and adulthood.…”