• Benjamin L Ranard, Murad Megjhani, Kalijah Terilli, Hirad Yarmohammadi, John Ausiello, and Soojin Park.
• Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, United States of America.
• J Crit Care. 2022 Oct 1; 71: 154114154114.

PurposeTo examine the association between a measure of heart rate variability and sudden cardiac death (SCD) in COVID-19 patients.MethodsPatients with SARS-COV-2 infection admitted to Columbia University Irving Medical Center who died between 4/25/2020 and 7/14/2020 and had an autopsy were examined for root mean square of successive differences (RMSSD), organ weights, and evidence of SCD.ResultsThirty COVID-19 patients were included and 12 had SCD. The RMSSD over 7 days without vs with SCD was median 0.0129 (IQR 0.0074-0.026) versus 0.0098 (IQR 0.0056-0.0197), p < 0.0001. The total adjusted adrenal weight of the non-SCD group was 0.40 g/kg (IQR 0.35-0.55) versus 0.25 g/kg (IQR 0.21-0.31) in the SCD group, p = 0.0007.ConclusionsHospitalized patients with COVID-19 who experienced SCD had lower parasympathetic activity (RMSSD) and smaller sized adrenal glands. Further research is required to replicate these findings.Copyright © 2022 Elsevier Inc. All rights reserved.

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