Heart-rate-variability (HRV), predicts outcomes in COVID-19

<h4>Background</h4> Patients with COVID-19 present with a variety of clinical manifestations, ranging from mild or asymptomatic disease to severe illness and death. Whilst previous studies have clarified these and several other aspects of COVID-19, one of the ongoing challenges regarding...

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Autores principales:	Maartje B. A. Mol, Maud T. A. Strous, Frits H. M. van Osch, F. Jeroen Vogelaar, Dennis G. Barten, Moshe Farchi, Norbert A. Foudraine, Yori Gidron
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/30ed7b1550eb4a15ab2ebb3937a54868
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spelling	oai:doaj.org-article:30ed7b1550eb4a15ab2ebb3937a548682021-11-04T06:49:38ZHeart-rate-variability (HRV), predicts outcomes in COVID-191932-6203https://doaj.org/article/30ed7b1550eb4a15ab2ebb3937a548682021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8553073/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4> Patients with COVID-19 present with a variety of clinical manifestations, ranging from mild or asymptomatic disease to severe illness and death. Whilst previous studies have clarified these and several other aspects of COVID-19, one of the ongoing challenges regarding COVID-19 is to determine which patients are at risk of adverse outcomes of COVID-19 infection. It is hypothesized that this is the result of insufficient inhibition of the immune response, with the vagus nerve being an important neuro-immuno-modulator of inflammation. Vagus nerve activity can be non-invasively indexed by heart-rate-variability (HRV). Therefore, we aimed to assess the prognostic value of HRV, as a surrogate marker for vagus nerve activity, in predicting mortality and intensive care unit (ICU) referral, in patients hospitalized with COVID-19. <h4>Methods</h4> A retrospective cohort study including all consecutive patients (n = 271) diagnosed and hospitalized with COVID-19 between March 2020 and May 2020, without a history of cardiac arrhythmias (including atrial and ventricular premature contractions), pacemaker, or current bradycardia (heart rate <50 bpm) or tachycardia (heart rate >110 bpm). HRV was based on one 10s ECG recorded at admission. 3-week survival and ICU referral were examined. <h4>Results</h4> HRV indexed as standard deviation of normal to normal heartbeat intervals (SDNN) predicted survival (H.R. = 0.53 95%CI: 0.31–0.92). This protective role was observed only in patients aged 70 years and older, not in younger patients. HRV below median value also predicted ICU referral within the first week of hospitalization (H.R = 0.51, 95%CI: 0.29–0.90, P = 0.021). <h4>Conclusion</h4> Higher HRV predicts greater chances of survival, especially in patients aged 70 years and older with COVID-19, independent of major prognostic factors. Low HRV predicts ICU indication and admission in the first week after hospitalization.Maartje B. A. MolMaud T. A. StrousFrits H. M. van OschF. Jeroen VogelaarDennis G. BartenMoshe FarchiNorbert A. FoudraineYori GidronPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Maartje B. A. Mol Maud T. A. Strous Frits H. M. van Osch F. Jeroen Vogelaar Dennis G. Barten Moshe Farchi Norbert A. Foudraine Yori Gidron Heart-rate-variability (HRV), predicts outcomes in COVID-19
description	<h4>Background</h4> Patients with COVID-19 present with a variety of clinical manifestations, ranging from mild or asymptomatic disease to severe illness and death. Whilst previous studies have clarified these and several other aspects of COVID-19, one of the ongoing challenges regarding COVID-19 is to determine which patients are at risk of adverse outcomes of COVID-19 infection. It is hypothesized that this is the result of insufficient inhibition of the immune response, with the vagus nerve being an important neuro-immuno-modulator of inflammation. Vagus nerve activity can be non-invasively indexed by heart-rate-variability (HRV). Therefore, we aimed to assess the prognostic value of HRV, as a surrogate marker for vagus nerve activity, in predicting mortality and intensive care unit (ICU) referral, in patients hospitalized with COVID-19. <h4>Methods</h4> A retrospective cohort study including all consecutive patients (n = 271) diagnosed and hospitalized with COVID-19 between March 2020 and May 2020, without a history of cardiac arrhythmias (including atrial and ventricular premature contractions), pacemaker, or current bradycardia (heart rate <50 bpm) or tachycardia (heart rate >110 bpm). HRV was based on one 10s ECG recorded at admission. 3-week survival and ICU referral were examined. <h4>Results</h4> HRV indexed as standard deviation of normal to normal heartbeat intervals (SDNN) predicted survival (H.R. = 0.53 95%CI: 0.31–0.92). This protective role was observed only in patients aged 70 years and older, not in younger patients. HRV below median value also predicted ICU referral within the first week of hospitalization (H.R = 0.51, 95%CI: 0.29–0.90, P = 0.021). <h4>Conclusion</h4> Higher HRV predicts greater chances of survival, especially in patients aged 70 years and older with COVID-19, independent of major prognostic factors. Low HRV predicts ICU indication and admission in the first week after hospitalization.
format	article
author	Maartje B. A. Mol Maud T. A. Strous Frits H. M. van Osch F. Jeroen Vogelaar Dennis G. Barten Moshe Farchi Norbert A. Foudraine Yori Gidron
author_facet	Maartje B. A. Mol Maud T. A. Strous Frits H. M. van Osch F. Jeroen Vogelaar Dennis G. Barten Moshe Farchi Norbert A. Foudraine Yori Gidron
author_sort	Maartje B. A. Mol
title	Heart-rate-variability (HRV), predicts outcomes in COVID-19
title_short	Heart-rate-variability (HRV), predicts outcomes in COVID-19
title_full	Heart-rate-variability (HRV), predicts outcomes in COVID-19
title_fullStr	Heart-rate-variability (HRV), predicts outcomes in COVID-19
title_full_unstemmed	Heart-rate-variability (HRV), predicts outcomes in COVID-19
title_sort	heart-rate-variability (hrv), predicts outcomes in covid-19
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/30ed7b1550eb4a15ab2ebb3937a54868
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Heart-rate-variability (HRV), predicts outcomes in COVID-19

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