The Effect of COVID-19 Infection on Cardiac Autonomic Function Using Heart Rate Variability in Male Veteran Twins Restricted; Files Only
Akoto, Natalie (Spring 2024)
Abstract
Background: Research suggests that COVID-19 may affect the cardiovascular system beyond the acute infection phase. Heart rate variability (HRV) emerges as a potential biomarker for assessing post-COVID autonomic effects. However, studies may be limited by unmeasured confounding. By studying twins, we can control for unmeasured familial factors and thereby increase internal validity.
Methods: Using a cross-sectional study design, we enrolled male veteran twins and collected self-reported data on recent (within one year) and distant COVID exposure via medical interview. Participants wore ambulatory Holter monitors for 7 days to assess HRV. Statistical analyses, including t-tests, chi-square tests, linear regression and ANOVA, and mixed models, were conducted using SAS software.
Results: The study involved 320 male veteran twins, of which 121 reported past COVID-19 infection. Among those with COVID-19, 87% (n=104) experienced symptoms, with 19% (n=23) having persistent symptoms. Recent COVID-19 cases (n=53) within the past year were associated with a 20% lower LF HRV compared to those never infected with COVID-19 (95%CI: -35.1, -0.5). We also observed a trend towards lower HF, RMSSD, and PNN50 among those with recent COVID-19 versus controls (HF: -21.9% (95% CI: -41.5,4.3); RMSSD: -12.2% (95% CI: -24.9,2.6); PNN50: -26.7%, (95% CI: -47.6,2.7)). Persistence of COVID-19 symptoms and resolved COVID-19 versus controls was associated with a -22.8% (95% CI: -43.4,5.4) and -9.50% (95% CI: -24.3,7.6) lower HRV, respectively, compared to those with no history of infection. When examining twin brothers discordant for COVID-19, we found similar effect sizes.
Conclusion: We found evidence to suggest reduced LF HRV in male veteran twins recently exposed to COVID-19 infection. Although most of the relationships did not reach statistical significance, many of the effect sizes were moderate, suggesting the need for more research in larger cohorts.
Table of Contents
Introduction Methods Results Discussion Bibliography
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File download under embargo until 20 May 2026 | 2024-04-22 17:59:51 -0400 | File download under embargo until 20 May 2026 |
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