Inappropriate sinus tachycardia in post-COVID-19 syndrome

Sci Rep. 2022 Jan 7;12(1):298. doi: 10.1038/s41598-021-03831-6.

Abstract

Inappropriate sinus tachycardia (IST) is a common observation in patients with post-COVID-19 syndrome (PCS) but has not yet been fully described to date. To investigate the prevalence and the mechanisms underlying IST in a prospective population of PCS patients. Consecutive patients admitted to the PCS Unit between June and December 2020 with a resting sinus rhythm rate ≥ 100 bpm were prospectively enrolled in this study and further examined by an orthostatic test, 2D echocardiography, 24-h ECG monitoring (heart rate variability was a surrogate for cardiac autonomic activity), quality-of-life and exercise capacity testing, and blood sampling. To assess cardiac autonomic function, a 2:1:1 comparative sub-analysis was conducted against both fully recovered patients with previous SARS-CoV-2 infection and individuals without prior SARS-CoV-2 infection. Among 200 PCS patients, 40 (20%) fulfilled the diagnostic criteria for IST (average age of 40.1 ± 10 years, 85% women, 83% mild COVID-19). No underlying structural heart disease, pro-inflammatory state, myocyte injury, or hypoxia were identified. IST was accompanied by a decrease in most heart rate variability parameters, especially those related to cardiovagal tone: pNN50 (cases 3.2 ± 3 vs. recovered 10.5 ± 8 vs. non-infected 17.3 ± 10; p < 0.001) and HF band (246 ± 179 vs. 463 ± 295 vs. 1048 ± 570, respectively; p < 0.001). IST is prevalent condition among PCS patients. Cardiac autonomic nervous system imbalance with decreased parasympathetic activity may explain this phenomenon.

MeSH terms

  • Adult
  • COVID-19 / complications*
  • COVID-19 / diagnosis
  • COVID-19 / pathology
  • COVID-19 / physiopathology
  • Female
  • Heart Rate
  • Humans
  • Male
  • Middle Aged
  • Myocardium / pathology
  • Post-Acute COVID-19 Syndrome
  • Prevalence
  • Prospective Studies
  • SARS-CoV-2 / isolation & purification
  • Tachycardia, Sinus / diagnosis
  • Tachycardia, Sinus / etiology*
  • Tachycardia, Sinus / pathology
  • Tachycardia, Sinus / physiopathology