• Sao Paulo Med J · Jan 2023

    Autonomic dysfunction in COVID-19 patients receiving mechanical ventilation: A cross-sectional study.

    • Renata Baltar da Silva, Victor Ribeiro Neves, Mayara Costa Barros, Bruno Bavaresco Gambassi, Paulo Adriano Schwingel, and Dário Celestino Sobral Filho.
    • PT, MSc. Physiotherapist and Doctoral Student, Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade de Pernambuco (UPE), Recife (PE), Brazil. Physiotherapist, Hospital das Clínicas of the Universidade Federal de Pernambuco (HC-UFPE), Empresa Brasileira de Serviços Hospitalares (EBSERH), Recife (PE), Brazil. Physiotherapist, Agamenon Magalhães Hospital (HAM), UPE, Recife (PE), Brazil.
    • Sao Paulo Med J. 2023 Jan 1; 141 (6): e2022513e2022513.

    BackgroundCoronavirus disease 2019 (COVID-19) can damage cardiac tissue by increasing troponin levels and inducing arrhythmias, myocarditis, and acute coronary syndrome.ObjectivesTo analyze the impact of COVID-19 on cardiac autonomic control in mechanically ventilated intensive care unit (ICU) patients.Design And SettingThis cross-sectional analytical study of ICU patients of both sexes receiving mechanical ventilation was conducted in a tertiary hospital.MethodsPatients were divided into COVID-19-positive (COVID(+)) and COVID-19-negative (COVID(-)) groups. Clinical data were collected and heart rate variability (HRV) records obtained using a heart rate monitor.ResultsThe study sample comprised 82 subjects: 36 (44%) in the COVID(-) group (58.3% female; median age, 64.5 years) and 46 (56%) in the COVID(+) group (39.1% females; median age, 57.5 years). The HRV indices were lower than the reference values. An intergroup comparison identified no statistically significant differences in the mean normal-to-normal (NN) interval, standard deviation of the NN interval, or root mean square of successive differences in NN intervals. The COVID(+) group had an increased low frequency (P = 0.05), reduced high frequency (P = 0.045), and increased low frequency/high frequency (LF/HF) ratio (P = 0.048). There was a weak positive correlation between LF/HF and length of stay in the COVID(+) group.ConclusionPatients who received mechanical ventilation had lower overall HRV indices. COVID(+) patients who received mechanical ventilation had lower vagal HRV components. These findings likely indicate clinical applicability, as autonomic control impairments are associated with a greater risk of cardiac death.

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