Frontiers in Physiology (May 2021)
Alteration of Autonomic Nervous System Is Associated With Severity and Outcomes in Patients With COVID-19
- Yuchen Pan,
- Yuchen Pan,
- Yuchen Pan,
- Yuchen Pan,
- Zhiyao Yu,
- Zhiyao Yu,
- Zhiyao Yu,
- Zhiyao Yu,
- Yuan Yuan,
- Yuan Yuan,
- Yuan Yuan,
- Yuan Yuan,
- Jiapeng Han,
- Jiapeng Han,
- Jiapeng Han,
- Jiapeng Han,
- Zhuo Wang,
- Zhuo Wang,
- Zhuo Wang,
- Zhuo Wang,
- Hui Chen,
- Hui Chen,
- Hui Chen,
- Hui Chen,
- Songyun Wang,
- Songyun Wang,
- Songyun Wang,
- Songyun Wang,
- Zhen Wang,
- Zhen Wang,
- Zhen Wang,
- Zhen Wang,
- Huihui Hu,
- Huihui Hu,
- Huihui Hu,
- Huihui Hu,
- Liping Zhou,
- Liping Zhou,
- Liping Zhou,
- Liping Zhou,
- Yanqiu Lai,
- Yanqiu Lai,
- Yanqiu Lai,
- Yanqiu Lai,
- Zhen Zhou,
- Zhen Zhou,
- Zhen Zhou,
- Zhen Zhou,
- Yuhong Wang,
- Yuhong Wang,
- Yuhong Wang,
- Yuhong Wang,
- Guannan Meng,
- Guannan Meng,
- Guannan Meng,
- Guannan Meng,
- Lilei Yu,
- Lilei Yu,
- Lilei Yu,
- Lilei Yu,
- Hong Jiang,
- Hong Jiang,
- Hong Jiang,
- Hong Jiang
Affiliations
- Yuchen Pan
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Yuchen Pan
- Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, China
- Yuchen Pan
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Yuchen Pan
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Zhiyao Yu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Zhiyao Yu
- Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, China
- Zhiyao Yu
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Zhiyao Yu
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Yuan Yuan
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Yuan Yuan
- Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, China
- Yuan Yuan
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Yuan Yuan
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Jiapeng Han
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Jiapeng Han
- Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, China
- Jiapeng Han
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Jiapeng Han
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Zhuo Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Zhuo Wang
- Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, China
- Zhuo Wang
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Zhuo Wang
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Hui Chen
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Hui Chen
- Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, China
- Hui Chen
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Hui Chen
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Songyun Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Songyun Wang
- Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, China
- Songyun Wang
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Songyun Wang
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Zhen Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Zhen Wang
- Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, China
- Zhen Wang
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Zhen Wang
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Huihui Hu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Huihui Hu
- Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, China
- Huihui Hu
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Huihui Hu
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Liping Zhou
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Liping Zhou
- Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, China
- Liping Zhou
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Liping Zhou
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Yanqiu Lai
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Yanqiu Lai
- Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, China
- Yanqiu Lai
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Yanqiu Lai
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Zhen Zhou
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Zhen Zhou
- Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, China
- Zhen Zhou
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Zhen Zhou
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Yuhong Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Yuhong Wang
- Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, China
- Yuhong Wang
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Yuhong Wang
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Guannan Meng
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Guannan Meng
- Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, China
- Guannan Meng
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Guannan Meng
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Lilei Yu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Lilei Yu
- Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, China
- Lilei Yu
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Lilei Yu
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Hong Jiang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Hong Jiang
- Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, China
- Hong Jiang
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Hong Jiang
- Hubei Key Laboratory of Cardiology, Wuhan, China
- DOI
- https://doi.org/10.3389/fphys.2021.630038
- Journal volume & issue
-
Vol. 12
Abstract
BackgroundPrevious studies suggest that coronavirus disease 2019 (COVID-19) is a systemic infection involving multiple systems, and may cause autonomic dysfunction.ObjectiveTo assess autonomic function and relate the findings to the severity and outcomes in COVID-19 patients.MethodsWe included consecutive patients with COVID-19 admitted to the 21st COVID-19 Department of the east campus of Renmin Hospital of Wuhan University from February 6 to March 7, 2020. Clinical data were collected. Heart rate variability (HRV), N-terminal pro-B-type natriuretic peptide (NT-proBNP), D-dimer, and lymphocytes and subsets counts were analysed at two time points: nucleic-acid test positive and negative. Psychological symptoms were assessed after discharge.ResultsAll patients were divided into a mild group (13) and a severe group (21). The latter was further divided into two categories according to the trend of HRV. Severe patients had a significantly lower standard deviation of the RR intervals (SDNN) (P < 0.001), standard deviation of the averages of NN intervals (SDANN) (P < 0.001), and a higher ratio of low- to high-frequency power (LF/HF) (P = 0.016). Linear correlations were shown among SDNN, SDANN, LF/HF, and laboratory indices (P < 0.05). Immune function, D-dimer, and NT-proBNP showed a consistent trend with HRV in severe patients (P < 0.05), and severe patients without improved HRV parameters needed a longer time to clear the virus and recover (P < 0.05).ConclusionHRV was associated with the severity of COVID-19. The changing trend of HRV was related to the prognosis, indicating that HRV measurements can be used as a non-invasive predictor for clinical outcome.
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