Association of heart rate variability with cardiorespiratory fitness and muscle strength in patients after hospitalization for COVID-19: An analytical cross-sectional study

Abstract

Introduction: Patients with a moderate to severe clinical condition of COVID-19 who need hospitalization may have dysfunction in Cardiac Autonomic Control (CAC) and functional capacity.

Objective: To assess the association of HRV with cardiorespiratory fitness and respiratory and peripheral muscle strength in patients after hospitalization for COVID-19.

Method: Cross-sectional study with individuals > 18-years old, post-hospitalization for COVID-19, with a positive RT-PCR test. Data on clinical condition and hospital admission were collected, and parameters of respiratory and peripheral muscle strength and functional capacity were evaluated with the 6-Minute Walk Test (6MWT). CAC was assessed by analyzing (Heart Rate Variability) HRV in the time (SDNN, RMSSD) and frequency domains (HF, LF, HF/LF ratio). Pearson correlation was performed between HRV measures and functional parameters.

Results: The results showed low HRV in study participants, with positive correlations between 6MWT and RMSSD and between SDNN and HF power and negative correlations between Heart Rate and the LF/HF ratio. On the other hand, respiratory and peripheral muscle strength correlated positively with parameters that represent sympathetic nervous system expression (LF nu and LF power) and negatively with the LF/HF ratio. However, changes in HRV parameters were not associated with disease severity.

Conclusion: The dysautonomia of COVID-19 patients was correlated with functional sequelae, though not associated with disease severity parameters. There was low HRV, with low vagal expression, and imbalance in sympathetic/parasympathetic modulation in the study group.

Keywords: Autonomic Nervous System; COVID-19; Heart Rate; Muscle Strength; Walk Test.