Autonomic dysfunction in COVID-19 patients receiving mechanical ventilation: A cross-sectional study.

Autor:	Silva RBD; PT, MSc. Physiotherapist and Doctoral Student, Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade de Pernambuco (UPE), Recife (PE), Brazil. Physiotherapist, Hospital das Clínicas of the Universidade Federal de Pernambuco (HC-UFPE), Empresa Brasileira de Serviços Hospitalares (EBSERH), Recife (PE), Brazil. Physiotherapist, Agamenon Magalhães Hospital (HAM), UPE, Recife (PE), Brazil., Neves VR; PT, PhD. Physiotherapist and Adjunct Professor, Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGRDF), Universidade de Pernambuco (UPE), Petrolina (PE), Brazil., Barros MC; PT. Physiotherapist and Master's Student, Programa de Pós-Graduação em Saúde Translacional (PPGST), Universidade Federal de Pernambuco (UFPE), Recife (PE), Brazil., Gambassi BB; PhD. Physical Educator and Adjunct Professor, Programa de Pós-Graduação em Gestão de Programas e Serviços de Saúde (MGPSS), Universidade Ceuma (UniCEUMA), São Luís (MA), Brazil., Schwingel PA; PhD. Sports Physiologist and Associate Professor, Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade de Pernambuco (UPE), Recife (PE), Brazil., Sobral Filho DC; MD, PhD. Physician and Associate Professor, Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade de Pernambuco (UPE), Recife (PE), Brazil.
Jazyk:	angličtina
Zdroj:	Sao Paulo medical journal = Revista paulista de medicina [Sao Paulo Med J] 2023 Apr 17; Vol. 141 (6), pp. e2022513. Date of Electronic Publication: 2023 Apr 17 (Print Publication: 2023).
DOI:	10.1590/1516-3180.2022.0513.R1.09022023
Abstrakt:	Background: Coronavirus disease 2019 (COVID-19) can damage cardiac tissue by increasing troponin levels and inducing arrhythmias, myocarditis, and acute coronary syndrome. Objectives: To analyze the impact of COVID-19 on cardiac autonomic control in mechanically ventilated intensive care unit (ICU) patients. Design and Setting: This cross-sectional analytical study of ICU patients of both sexes receiving mechanical ventilation was conducted in a tertiary hospital. Methods: Patients were divided into COVID-19-positive (COVID(+)) and COVID-19-negative (COVID(-)) groups. Clinical data were collected and heart rate variability (HRV) records obtained using a heart rate monitor. Results: The study sample comprised 82 subjects: 36 (44%) in the COVID(-) group (58.3% female; median age, 64.5 years) and 46 (56%) in the COVID(+) group (39.1% females; median age, 57.5 years). The HRV indices were lower than the reference values. An intergroup comparison identified no statistically significant differences in the mean normal-to-normal (NN) interval, standard deviation of the NN interval, or root mean square of successive differences in NN intervals. The COVID(+) group had an increased low frequency (P = 0.05), reduced high frequency (P = 0.045), and increased low frequency/high frequency (LF/HF) ratio (P = 0.048). There was a weak positive correlation between LF/HF and length of stay in the COVID(+) group. Conclusion: Patients who received mechanical ventilation had lower overall HRV indices. COVID(+) patients who received mechanical ventilation had lower vagal HRV components. These findings likely indicate clinical applicability, as autonomic control impairments are associated with a greater risk of cardiac death.
Databáze:	MEDLINE
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