Impact of COVID-19 on cardiac autonomic function in healthy young adults: potential role of symptomatology and time since diagnosis

Emerging evidence suggests COVID-19 may affect cardiac autonomic function; however, the limited findings in young adults with COVID-19 have been equivocal. Notably, symptomology and time since diagnosis appear to influence vascular health following COVID-19, but this has not been explored in the context of cardiac autonomic regulation. Therefore, we hypothesized that young adults who had persistent symptoms following COVID-19 would have lower heart rate variability (HRV) and cardiac baroreflex sensitivity (BRS) compared to those who had COVID-19 but were asymptomatic at testing and controls who never had COVID-19. Further, we hypothesized that there would be relationships between cardiac autonomic function measures and time since diagnosis. We studied 27 adults who had COVID-19 and were either asymptomatic (ASYM; n=15 (6 female); 21±4 years; 8.4±4.0 weeks from diagnosis) or symptomatic (SYM; n=12 (9 female); 24±3 years; 12.3±6.2 weeks from diagnosis) at testing, and 20 adults who reported never having COVID-19 (24±4 years, 11 female). Heart rate and beat-to-beat blood pressure were continuously recorded during 5-minutes of rest to assess HRV and cardiac BRS. HRV (root mean square of successive differences between normal heartbeats [RMSSD]; control: 73±50ms; ASYM: 71±47ms; SYM: 84±45ms; p=0.774) and cardiac BRS (overall gain; control: 22.3±10.1ms/mmHg; ASYM: 22.7±12.2ms/mmHg; SYM: 24.3±10.8ms/mmHg; p=0.871) were not different between groups. However, we found correlations with time since diagnosis for HRV (e.g., RMSSD: r=0.460, p=0.016) and cardiac BRS (overall gain, r=0.470, p=0.014). These data suggest a transient impact of COVID-19 on cardiac autonomic function that appears mild and unrelated to persistent symptoms in young adults.

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