Savulescu-Fiedler Ilinca, Deaconu Teodora, Siliste Roxana, Homentcovschi Corina, Gurghean Adriana, Toader Ioana, Benea Serban
MD, PhD, Department of Internal Medicine, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474, Bucharest, and Department of Internal Medicine, Coltea Clinical Hospital, Bucharest, 030167, Romania.
MD, National Institute for Infectious Diseases "Prof. Dr. Matei Bals", Bucharest, 021105, Romania.
Germs. 2025 Jun 30;15(2):104-115. doi: 10.18683/germs.2025.1460. eCollection 2025 Jun.
Inflammation may induce dysautonomia, which is revealed by the decrease in heart rate variability (HRV) parameters. Our pilot study compares changes in HRV and the association between HRV and inflammatory markers in three RNA viral infections: acute (SARS-CoV-2, measles) and chronic (HIV).
We evaluated 25 patients with viral infections and 8 control patients without viral disease, with similar mean age and comorbidities. Patients with measles and COVID-19 were hospitalized for mild to moderate respiratory symptoms, while those with HIV were assessed during follow-up visits. HRV parameters were assessed in time and spectral domains, under standardized conditions.
Significant differences were identified between patients with measles and COVID-19 regarding SDNN (p=0.016), rMSSD (p=0.002), and between patients with COVID-19 and HIV, both for SDNN (p=0.029) and rMSSD (p=0.017). SDNN and rMSSD had the highest value in the COVID-19 group and the lowest value (lower than in the control group) in patients with HIV and measles. All frequency-domain parameters reached their highest values in patients with COVID-19, whereas they were consistently lower in those with HIV and measles. A significant correlation of LF/HF ratio with serum fibrinogen was observed only in patients with measles and HIV infection (r=0.793, p=0.011, respectively r=0.955, p<0.001).
Our study showed a significant decrease in HRV parameters in patients with measles and HIV, with a more stable autonomic response in mild-moderate COVID-19 forms. A correlation between inflammation and markers of sympathetic dominance was found in patients with measles and HIV but not in COVID-19. Further studies may assess the relation between inflammation in viral infections and subtle changes in HRV parameters.
炎症可能诱发自主神经功能障碍，这可通过心率变异性（HRV）参数的降低来体现。我们的初步研究比较了三种RNA病毒感染（急性感染：严重急性呼吸综合征冠状病毒2 [SARS-CoV-2]、麻疹；慢性感染：人类免疫缺陷病毒[HIV]）中HRV的变化以及HRV与炎症标志物之间的关联。
我们评估了25例病毒感染患者和8例无病毒疾病的对照患者，两组患者的平均年龄和合并症相似。麻疹患者和新型冠状病毒肺炎（COVID-19）患者因轻至中度呼吸道症状住院，而HIV患者在随访期间接受评估。在标准化条件下，从时域和频域评估HRV参数。
麻疹患者与COVID-19患者在标准差（SDNN）（p = 0.016）、相邻RR间期差值的均方根（rMSSD）（p = 0.002）方面存在显著差异；COVID-19患者与HIV患者在SDNN（p = 0.029）和rMSSD（p = 0.017）方面也存在显著差异。SDNN和rMSSD在COVID-19组中值最高，在HIV患者和麻疹患者中值最低（低于对照组）。所有频域参数在COVID-19患者中达到最高值，而在HIV患者和麻疹患者中则持续较低。仅在麻疹患者和HIV感染患者中观察到低频/高频（LF/HF）比值与血清纤维蛋白原之间存在显著相关性（分别为r = 0.793，p = 0.011；r = 0.955，p < 0.001）。
我们的研究表明，麻疹患者和HIV患者的HRV参数显著降低，而轻至中度COVID-19患者的自主神经反应更稳定。在麻疹患者和HIV患者中发现炎症与交感神经优势标志物之间存在相关性，但在COVID-19患者中未发现。进一步的研究可评估病毒感染中的炎症与HRV参数细微变化之间的关系。
