Heart rate variability as an indicator of COVID-19 induced myocardial injury: a retrospective cohort study

BMC Anesthesiol. 2023 Jan 10;23(1):17. doi: 10.1186/s12871-023-01975-8.


Background: Heart rate variability (HRV) is a valuable indicator of autonomic nervous system integrity and can be a prognostic tool of COVID-19 induced myocardial affection. This study aimed to compare HRV indices between patients who developed myocardial injury and those without myocardial injury in COVID-19 patients who were admitted to intensive care unit (ICU).

Methods: In this retrospective study, the data from 238 COVID-19 adult patients who were admitted to ICU from April 2020 to June 2021 were collected. The patients were assigned to myocardial injury and non-myocardial injury groups. The main collected data were R-R intervals, standard deviation of NN intervals (SDANN) and the root mean square of successive differences between normal heartbeats (RMSSD) that were measured daily during the first five days of ICU admission.

Results: The R-R intervals, the SDANN and the RMSSD were significantly shorter in the myocardial injury group than the non-myocardial group at the first, t second, third, fourth and the fifth days of ICU admission. There were no significant differences between the myocardial injury and the non-myocardial injury groups with regard the number of patients who needed mechanical ventilation, ICU length of stay and the number of ICU deaths.

Conclusions: From the results of this retrospective study, we concluded that the indices of HRV were greatly affected in COVID-19 patients who developed myocardial injury.

Keywords: Autonomic nervous system; COVID-19; Heart rate; Intensive care units; Length of stay.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Autonomic Nervous System
  • COVID-19* / complications
  • Heart Rate / physiology
  • Hospitalization
  • Humans
  • Retrospective Studies