Heart rate variability and adrenal size provide clues to sudden cardiac death in hospitalized COVID-19 patients

J Crit Care. 2022 Oct:71:154114. doi: 10.1016/j.jcrc.2022.154114. Epub 2022 Jul 18.

Abstract

Purpose: To examine the association between a measure of heart rate variability and sudden cardiac death (SCD) in COVID-19 patients.

Methods: Patients with SARS-COV-2 infection admitted to Columbia University Irving Medical Center who died between 4/25/2020 and 7/14/2020 and had an autopsy were examined for root mean square of successive differences (RMSSD), organ weights, and evidence of SCD.

Results: Thirty COVID-19 patients were included and 12 had SCD. The RMSSD over 7 days without vs with SCD was median 0.0129 (IQR 0.0074-0.026) versus 0.0098 (IQR 0.0056-0.0197), p < 0.0001. The total adjusted adrenal weight of the non-SCD group was 0.40 g/kg (IQR 0.35-0.55) versus 0.25 g/kg (IQR 0.21-0.31) in the SCD group, p = 0.0007.

Conclusions: Hospitalized patients with COVID-19 who experienced SCD had lower parasympathetic activity (RMSSD) and smaller sized adrenal glands. Further research is required to replicate these findings.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Autopsy
  • COVID-19*
  • Death, Sudden, Cardiac / epidemiology
  • Heart Rate
  • Humans
  • Risk Factors
  • SARS-CoV-2