Ceren İmran, Habip Fadime Bozduman
Ankara Abdurrahman Yurtaslan Oncology Education and Research Hospital, Department of Cardiology - Ankara, Turkey.
Rev Assoc Med Bras (1992). 2024 Sep 30;70(10):e20231789. doi: 10.1590/1806-9282.20231789. eCollection 2024.
The aim of this study was to demonstrate the effect of coronavirus disease 2019 on the cardiovascular autonomic system using heart rate variability in young individuals.
The study was designed retrospectively by scanning the 24-h Holter electrocardiography records of patients who applied to the Ankara Abdurrahman Yurtaslan Oncology Education and Research Hospital Cardiology outpatient clinic. The study group consisted of 492 patients under the age of 40 years, who did not have additional comorbidities or medication use and had prolonged symptoms after coronavirus disease 2019 during the pandemic. The control group, including 401 patients, was determined during the pre-pandemic period (before December 2019). Heart rate variability parameters were evaluated by scanning the 24-h Holter electrocardiography records of the patients and compared with the non-coronavirus disease 2019 group.
The median age of participants was 30 years. Standard deviation of normal RR intervals (SDNN) ≤100 ms was more prevalent in the study group (27 (6.7%) vs 73 (14.8%), p<0.001). In univariate logistic regression analysis, the presence of coronavirus disease 2019 [(OR 2.41, 95%CI 1.52-3.83), p<0.001] and age [(OR 1.04, 95%CI 1.01-1.07), p=0.016] had a significant effect on the probability of SDNN≤100. In multivariate logistic regression analysis, the presence of coronavirus disease 2019 [(OR 2.42, 95%CI 1.52-3.85), p<0.001] and age [(OR 2.42, 95%CI 1.52-3.85), p=0.016] had a significant effect on the probability of SDNN≤100. Frequency domain measures such as, high-frequency values were significantly higher in the study group (p=0.029). The study group's low-frequency/high frequency ratio was significantly lower (p=0.019). The low-frequency/high-frequency ratio's cut-off value was ≤2.77. for determining the differentiation between coronavirus disease 2019 positive and negative cases in the receiver operating characteristic analysis. The sensitivity rate was 80.7%. The area under the curve value is 0.546 (p=0.019).
This study showed that coronavirus disease 2019 causes reduced heart rate variability and increased parasympathetic activity in young patients. This may explain the prolonged symptoms after coronavirus disease 2019 infection.
本研究旨在通过心率变异性来证明2019冠状病毒病对年轻人心血管自主神经系统的影响。
本研究为回顾性设计，通过扫描前往安卡拉阿卜杜勒拉赫曼·于尔塔斯兰肿瘤教育与研究医院心内科门诊就诊患者的24小时动态心电图记录。研究组由492名40岁以下患者组成，这些患者无其他合并症或未使用药物，且在疫情期间感染2019冠状病毒病后症状持续较长时间。对照组包括401名患者，在疫情前时期（2019年12月之前）确定。通过扫描患者的24小时动态心电图记录来评估心率变异性参数，并与非2019冠状病毒病组进行比较。
参与者的中位年龄为30岁。正常RR间期标准差（SDNN）≤100毫秒在研究组中更为普遍（27例（6.7%）对73例（14.8%），p<0.001）。在单因素逻辑回归分析中，2019冠状病毒病的存在[（比值比2.41，95%置信区间1.52 - 3.83），p<0.001]和年龄[（比值比1.04，95%置信区间1.01 - 1.07），p = 0.016]对SDNN≤100的概率有显著影响。在多因素逻辑回归分析中，2019冠状病毒病的存在[（比值比2.42，95%置信区间1.52 - 3.85），p<0.001]和年龄[（比值比2.42，95%置信区间1.52 - 3.85），p = 0.016]对SDNN≤100的概率有显著影响。频域测量指标，如高频值在研究组中显著更高（p = 0.029）。研究组的低频/高频比值显著更低（p = 0.019）。在受试者工作特征分析中，低频/高频比值的截断值≤2.77用于确定2019冠状病毒病阳性和阴性病例之间的差异。灵敏度率为80.7%。曲线下面积值为0.546（p = 0.019）。
本研究表明，2019冠状病毒病导致年轻患者心率变异性降低和副交感神经活动增加。这可能解释了2019冠状病毒病感染后症状持续较长时间的原因。
