ArticleViruses2022
Impaired Vagal Activity in Long-COVID-19 Patients.
Article in Viruses, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 59 citations in OpenAlex.
- Neurocardiac Autonomic Dysfunction in Patients With Post-COVID-19 Condition: A Systematic Review and Meta-Analysis.European journal of neurology · 2026Pooled it
- The Impact of SARS-CoV-2 Infection on Heart Rate Variability: A Systematic Review of Observational Studies with Control Groups.International journal of environmental research and public health · 2023Pooled it
- Assessing autonomic nervous system imbalance in long COVID-19 patients through heart rate variability during tilt testing.Scientific reports · 2026Article
- Echocardiogram Testing in Patients with Post-COVID-19 Condition: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2026Review
- Understanding the role of psychological factors in long COVID: a network analysis approach.European journal of public health · 2026Article
- Long-Term Manifestations of COVID-19: A Review.Cureus · 2025Review
- Classification of Individuals With COVID-19 and Post-COVID-19 Condition and Healthy Controls Using Heart Rate Variability: Machine Learning Study With a Near-Real-Time Monitoring Component.Journal of medical Internet research · 2025Article
- Screening for postural orthostatic tachycardia syndrome using 24-hour electrocardiogram recording in patients with long coronavirus disease.Heart rhythm O2 · 2025Article
- Attenuated cardiac autonomic function in patients with long-COVID with impaired orthostatic hemodynamics.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025Article
- The impact of long COVID on heart rate variability: a cross-sectional study.BMC infectious diseases · 2025Article
- Core features and inherent diversity of post-acute infection syndromes.Frontiers in immunology · 2025Review
- Salivary cortisol in long COVID: a marker of broader stress system and circadian rhythm dysregulation.Frontiers in cellular and infection microbiology · 2025Article
- Normative data for the 10-min lean test in adults without orthostatic intolerance.Frontiers in neurology · 2025Article
- Vagal nerve stimulation for the management of long COVID symptoms.Infectious medicine · 2024Review
- Characterization model of the post COVID-19 condition based on immunological, biochemical, and cytokine markers.iScience · 2024Article
- Clinical utility of ambulatory ECG monitoring and 2D-ventricular strain for evaluation of post-COVID-19 ventricular arrhythmia.BMC cardiovascular disorders · 2024Observational
- Cardiopulmonary exercise testing in long covid shows the presence of dysautonomia or chronotropic incompetence independent of subjective exercise intolerance and fatigue.BMC cardiovascular disorders · 2024Article
- Post-COVID dysautonomias: what we know and (mainly) what we don't know.Nature reviews. Neurology · 2024Review
- Association of heart rate variability with cardiorespiratory fitness and muscle strength in patients after hospitalization for COVID-19: An analytical cross-sectional study.Clinics (Sao Paulo, Brazil) · 2024Article
- Long term follow-up of heart rate variability in healthcare workers with mild COVID-19.Frontiers in neurology · 2024Article
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Long-COVID-19 refers to the signs and symptoms that continue or develop after the “acute COVID-19” phase. These patients have an increased risk of multiorgan dysfunction, readmission, and mortality. In Long-COVID-19 patients, it is possible to detect a persistent increase in D-Dimer, NT-ProBNP, and autonomic nervous system dysfunction. To verify the dysautonomia hypothesis in Long-COVID-19 patients, we studied heart rate variability using 12-lead 24-h ECG monitoring in 30 Long-COVID-19 patients and 20 No-COVID patients. Power spectral analysis of heart rate variability was lower in Long-COVID-19 patients both for total power (7.46 ± 0.5 vs. 8.08 ± 0.6; p < 0.0001; Cohens-d = 1.12) and for the VLF (6.84 ± 0.8 vs. 7.66 ± 0.6; p < 0.0001; Cohens-d = 1.16) and HF (4.65 ± 0.9 vs. 5.33 ± 0.9; p = 0.015; Cohens-d = 0.76) components. The LF/HF ratio was significantly higher in Long-COVID-19 patients (1.46 ± 0.27 vs. 1.23 ± 0.13; p = 0.001; Cohens-d = 1.09). On multivariable analysis, Long-COVID-19 is significantly correlated with D-dimer (standardized β-coefficient = 0.259), NT-ProBNP (standardized β-coefficient = 0.281), HF component of spectral analysis (standardized β-coefficient = 0.696), and LF/HF ratio (standardized β-coefficient = 0.820). Dysautonomia may explain the persistent symptoms in Long COVID-19 patients. The persistence of a procoagulative state and an elevated myocardial strain could explain vagal impairment in these patients. In Long-COVID-19 patients, impaired vagal activity, persistent increases of NT-ProBNP, and a prothrombotic state require careful monitoring and appropriate intervention.
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Registered trials
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