BACKGROUND. Autonomic dysfunction may occur as a complication of acute infection
with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and may influence disease course and outcome. The most suitable method for assessing autonomic dysfunction in severely ill patients with complex pathology is heart rate variability. This study evaluates whether heart rate variability parameters can predict the course of hospitalization in adults with severe but non-critical acute SARS-CoV-2 infection. METHODS. In this retrospective study, we analyzed data from 30 adults with stage IV acute respiratory infection with SARS-CoV-2 who were hospitalized at the University Clinic of Respiratory and Allergic Diseases Golnik between October 11, 2021, and February 21, 2022. The disease severity was classified according to the United States National Institutes
of Health guidelines. Disease course was assessed based on the trend of respiratory failure improvement or deterioration after four days of treatment, the occurrence of thromboembolic complications, and the need for intensive care at any time during treatment.
RESULTS. Of the 30 included patients, 22 were male and 8 were female. The median age was 50 years, with a range of 29 to 70 years. Comparison of heart rate variability parameters during the acute phase of illness and at follow-up 1.5 years later showed statistically significantly higher values at follow-up. Patients with an uncomplicated disease course (n = 22) had significantly higher heart rate variability values at admission compared to patients with a complicated course (n = 8). DISCUSSION. The results suggest
that heart rate variability may serve as an important complementary predictive marker of a more favorable disease course in adults with acute SARS-CoV-2 infection. Early recognition of autonomic dysfunction may assist in risk stratification for complications and
contribute to optimization of clinical management.
|
