• Am. J. Med. · May 2024

    Heart rate variability modulation through slow paced breathing in Healthcare workers with Long-COVID: a case-control study.

    • Marcella Mauro, Luca Cegolon, Nicoletta Bestiaco, Elisa Zulian, and Larese FilonFrancescaFUnit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Trieste, Italy..
    • Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Trieste, Italy. Electronic address: mmauro@units.it.
    • Am. J. Med. 2024 May 23.

    BackgroundLong COVID is a syndrome persisting 12+ weeks after COVID-19 infection, impacting life and work ability. Autonomic nervous system imbalance has been hypothesized as the cause. This study aims to investigate cardiovascular autonomic function in health care workers (HCWs) with Long COVID and the effectiveness of slow-paced breathing (SPB) on autonomic modulation.MethodsFrom December 1, 2022 to March 31, 2023, 6655 HCWs of the University Hospitals of Trieste (Northeast Italy) were asked to participate in the study by company-email. Inclusion/exclusion criteria were assessed. Global health status and psychosomatic disorders were evaluated through validated questionnaires. Heart rate variability was assessed by finger-photoplethysmography during spontaneous breathing and SPB, which stimulate vagal response. Long COVID HCWs (G1) were contrasted with Never infected (G2) and Fully recovered COVID-19 workers (G3).ResultsThere were 126 HCWs evaluated. The 58 Long COVID were assessed at a median time because COVID-19 of 419.5 days (interquartile range 269-730) and had significantly more psychosomatic symptoms and lower detectability of spontaneous systolic pressure oscillation at 0.1 Hz (Mayer wave - baroreflex arc) during spontaneous breathing compared with 53 never-infected and 14 fully-recovered HCWs (19%, 42%, and 40%, respectively, P = .027). During SPB, the increase in this parameter was close to controls (91.2%, 100%, and 100%, respectively, P = .09). No other differences in heart rate variability parameters were found among groups.ConclusionsResting vascular modulation was reduced in Long COVID, while during SPB, baroreflex sensitivity effectively improved. Long-term studies are needed to evaluate whether multiple sessions of breathing exercises can restore basal vascular reactivity and reduce cardiovascular risk in these patients.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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