2026/03/01 by Daniela Schoene, Stefanie Deckert, Kristian Barlinn +3 · 1 voice
Medicine · #Long-Term Effects of COVID-19 #Heart Rate Variability and Autonomic Control #Cardiovascular Syncope and Autonomic Disorders
paper · doi:10.1111/ene.70561
ABSTRACT Background Neurocardiac autonomic impairment with reduced heart rate variability (HRV) has been linked to SARS‐CoV‐2 infection and may persist in patients with post‐COVID‐19 syndrome. We synthesised meta‐analytic data on HRV in post‐COVID‐19 syndrome. Methods Our systematic review and meta‐analysis were guided by PRISMA standards. We used MEDLINE, Embase and Web of Science to identify non‐randomised studies of HRV in patients with post‐COVID‐19 syndrome, conducted more than 3 months after infection and compared with healthy controls. The search covered the period from 01/2020 to 09/2023. We pooled data on the following HRV parameters: standard deviation of normal‐to‐normal intervals (SDNN), root mean square of successive differences (rMSSD) and low‐frequency to high‐frequency ratio (LF/HF ratio). We applied a random effects model to account for heterogeneity. Risk of bias was assessed. Results From 856 initially identified records, we included 11 studies with a total of 1162 participants (593 post‐COVID‐19 patients and 565 healthy controls). We observed a trend toward lower HRV in post‐COVID patients compared to controls, with small to medium effects for SDNN (SMD: 0.26, 95% CI: −0.03 to 0.56, p = 0.09), rMSSD (SMD: 0.11, 95% CI: −0.15 to 0.36, p = 0.41) and LF/HF ratio (SMD: –0.271, 95% CI: −0.61 to 0.07, p = 0.12). Moderate to high statistical heterogeneity of the effects was observed (I 2 = 83% for SDNN and 78% for rMSSD) and nine of 11 studies had a high risk of bias. Conclusion This meta‐analysis suggests a possible association between post‐COVID condition and alterations in neurocardiac autonomic function.