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)
Published
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.
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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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