The Contribution of Psychological Distress to Resting Palpitations in Patients Who Recovered from Severe COVID-19

Abstract

Bing Huang,1– 4 Hui Yan,2 Limei Hu,1,3,4 Guiqiu Cao,2 Guipeng Wang,2 Jing Meng,2 Wanting Li,5 Gang Liu,2 Juan Wang,2 Wenqing Le,5 Hong Jiang1,3,4 1Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China; 2Department of Cardiology, Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China; 3Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei, People’s Republic of China; 4Hubei Key Laboratory of Cardiology, Wuhan, Hubei, People’s Republic of China; 5Department of Critical Care, Wuhan Hankou Hospital, Wuhan, Hubei, People’s Republic of ChinaCorrespondence: Hong JiangDepartment of Cardiology, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuchang District, Wuhan City, Hubei Province, 430060, People’s Republic of ChinaTel [phone]Fax [phone]Email [email protected] CaoDepartment of Cardiology, Fifth Affiliated Hospital of Xinjiang Medical University, No. 118 Henan Road, Xinshi District, Urumqi, Xinjiang, 830000, People’s Republic of ChinaTel/Fax [phone]Email [email protected]: Increasing numbers of patients have recovered from severe coronavirus disease 2019 (COVID-19) in Wuhan, China. This study aimed to evaluate the association of psychological distress with resting palpitations in recovered patients.Methods: In this prospective cohort study, consecutive patients who recovered from severe COVID-19 and complained of resting palpitations were included. Dynamic electrocardiogram (ECG) was continuously monitored for 2 hours while patients were at rest. A survey using a palpitation frequency scale and the Hospital Anxiety and Depression Scale (HADS) was administered to all participants.Results: Of the 289 consecutive patients who recovered from severe COVID-19, 24 patients (8.3%) suffered resting palpitation symptoms, and 22 patients were finally included. Two-hour Holter monitoring showed that 18 (81.8%) patients had tachyarrhythmias, of which the most common was sinus tachycardia (17/22, 77.3%). However, patients with sinus tachycardia showed a similar frequency of palpitation episodes compared to those without sinus tachycardia. Anxiety (68.2%) and depression (59.1%) were prevalent among these recovered patients. Patients with anxiety or depression symptoms had a higher frequency of palpitation episodes than those without anxiety or depression symptoms. In addition, both the HADS-anxiety score (r =0.609, P< 0.01) and HADS-depression score (r =0.516, P=0.01) were positively related to the frequency of palpitation episodes.Conclusion: Symptoms of resting palpitations, manifested mainly by sinus tachycardia, are not uncommon in patients who recovered from severe COVID-19. Psychological distress (anxiety and depression) may be responsible, at least in part, for resting palpitation symptoms.Keywords: coronavirus disease 2019, palpitations, sinus tachycardia, anxiety, depression

Keywords

• coronavirus disease 2019
• palpitations
• sinus tachycardia
• anxiety
• depression