Salem Ayad Mohammed, Yar Talay, Al Eid Mohammed, Almahfoudh Husain, Alsaffar Mohammed, Al Ibrahim Abdullah, Almadan Ali, Alaidarous Sana, Almulhim Razan, Rafique Nazish, Latif Rabia, Siddiqui Intisar Ahmad, Alsunni Ahmed
Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Int J Gen Med. 2022 Sep 30;15:7593-7603. doi: 10.2147/IJGM.S382331. eCollection 2022.
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.
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).
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.
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.
近期研究报告称，新冠病毒感染具有长期影响，不仅超出了急性期疾病范畴，还会扰乱呼吸系统之外的各种身体系统。本研究旨在调查严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染对至少在3个月前感染过该病毒的患者心血管自主神经活动、反应性和敏感性的急性后效应。
这是一项比较性横断面观察研究。59名受试者被分为两组，对照组（n = 31），无新冠病毒感染阳性史；新冠后患者组（n = 28），在通过逆转录聚合酶链反应（RT-PCR）检测出SARS-CoV-2呈阳性后3至8个月被招募。通过记录基线心率变异性（HRV）评估基线心血管自主神经活动，通过标准心血管自主神经反射测试（CART）确定自主神经反应性，通过心脏压力感受器敏感性（cBRS）评估心脏自主神经敏感性。
与对照组相比，新冠后患者体位性低血压的发生率更高（分别为39.3%和3.2%，p < 0.001）。此外，新冠后组握力测试以及头高位倾斜时的心率反应显著降低（p < 0.001）。与对照组相比，约85.7%的新冠后参与者至少有一项异常心血管反射测试（CART）（p < 0.）。尽管新冠后19组的HRV参数（TP、LF、HF、SDRR、RMSSD、pRR50）和cBRS在数值上较低，但未达到显著水平。
本研究结果提示急性新冠后患者心血管反应性发生改变，需要进一步调查和长期随访。
