International Journal of General Medicine (Sep 2022)

Post-Acute Effect of SARS-CoV-2 Infection on the Cardiac Autonomic Function

  • Salem AM,
  • Yar T,
  • Al Eid M,
  • Almahfoudh H,
  • Alsaffar M,
  • Al Ibrahim A,
  • Almadan A,
  • Alaidarous S,
  • Almulhim R,
  • Rafique N,
  • Latif R,
  • Siddiqui IA,
  • Alsunni A

Journal volume & issue
Vol. Volume 15
pp. 7593 – 7603

Abstract

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Ayad Mohammed Salem,1 Talay Yar,1 Mohammed Al Eid,2 Husain Almahfoudh,2 Mohammed Alsaffar,2 Abdullah Al Ibrahim,2 Ali Almadan,2 Sana Alaidarous,2 Razan Almulhim,2 Nazish Rafique,1 Rabia Latif,1 Intisar Ahmad Siddiqui,3 Ahmed Alsunni1 1Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3Department of Dental Education, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Ayad Mohammed Salem, Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, PO Box 2114-31451, Dammam, Saudi Arabia, Email [email protected]: Recent studies reported a long-lasting effect of COVID-19 infection that extends beyond the active disease and disrupts various body systems besides the respiratory system. The current study aims to investigate the post-acute effect of SARS-CoV-2 infection on cardiovascular autonomic activity, reactivity and sensitivity in patients who had the infection at least 3 months before.Methods: This was a comparative cross-sectional observational study. Fifty-nine subjects were allocated into two groups, controls (n=31), who had no history of positive COVID-19 infection, and the post-COVID patients (n=28) who were recruited 3 to 8 months after testing positive for SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR). Baseline cardiovascular autonomic activity was evaluated through recording of baseline heart rate variability (HRV), autonomic reactivity was determined through standard cardiovascular autonomic reflex tests (CART), and cardiac autonomic sensitivity was assessed through cardiac baroreceptor sensitivity (cBRS).Results: Higher incidence of orthostatic hypotension was observed in post-COVID patients compared to controls (39.3% and 3.2%, respectively, p < 0.001). Additionally, significantly reduced handgrip test, and heart rate response to head-up tilt was illustrated in the post-COVID group (p < 0.001). About 85.7% of post-COVID participants had at least one abnormal cardiovascular reflex test (CART) compared to the control group (p < 0.001). Although HRV parameters (TP, LF, HF, SDRR, RMSSD, pRR50), and the cBRS were numerically lower in the post-COVID-19 group, this did not reach the level of significance.Conclusion: The results of the present study are suggestive of altered cardiovascular reactivity in post-acute COVID patients and demand further investigation and longer term follow up.Keywords: COVID-19, autonomic nervous system, HRV, CART, baroreceptor sensitivity

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