Background Previous studies suggest that coronavirus disease 2019 (COVID-19) is a systemic infection involving multiple systems, and may cause autonomic dysfunction. Objective To assess autonomic function and relate the findings to the severity and outcomes in COVID-19 patients. Methods We included consecutive patients with COVID-19 admitted to the 21st COVID-19 Department of the east campus of Renmin Hospital of Wuhan University from February 6 to March 7, 2020. Clinical data were collected. Heart rate variability (HRV), N-terminal pro-B-type natriuretic peptide (NT-proBNP), D -dimer, and lymphocytes and subsets counts were analysed at two time points: nucleic-acid test positive and negative. Psychological symptoms were assessed after discharge. Results All patients were divided into a mild group (13) and a severe group (21). The latter was further divided into two categories according to the trend of HRV. Severe patients had a significantly lower standard deviation of the RR intervals (SDNN) ( P < 0.001), standard deviation of the averages of NN intervals (SDANN) ( P < 0.001), and a higher ratio of low- to high-frequency power (LF/HF) ( P = 0.016). Linear correlations were shown among SDNN, SDANN, LF/HF, and laboratory indices ( P < 0.05). Immune function, D -dimer, and NT-proBNP showed a consistent trend with HRV in severe patients ( P < 0.05), and severe patients without improved HRV parameters needed a longer time to clear the virus and recover ( P < 0.05). Conclusion HRV was associated with the severity of COVID-19. The changing trend of HRV was related to the prognosis, indicating that HRV measurements can be used as a non-invasive predictor for clinical outcome.
【저자키워드】 COVID-19, D-dimer, clinical outcomes, lymphocyte, heart rate variability, Autonomic nervous system, N-terminal pro-B-type natriuretic peptide, 【초록키워드】 coronavirus disease, Prognosis, severity, Infection, outcome, virus, discharge, Laboratory, Clinical outcome, severity of COVID-19, clinical, Wuhan, Patient, Mild, Severe patient, heart rate, university, NT-proBNP, COVID-19 patients, linear correlation, dysfunction, Standard deviation, Non-invasive, severe group, Variability, average, Renmin Hospital, previous study, Department, positive, significantly lower, parameter, N-terminal, HRV, objective, psychological symptom, Result, shown, collected, analysed, can be used, category, subset, interval, autonomic, consecutive patient, pro-B-type natriuretic peptide, was related, were assessed, with COVID-19, 【제목키워드】 alteration, System, nervous,