Assessment of long-term physiological and behavioral changes associated with COVID-19 infection
Radin JM, Quer G, Ramos E, et al. Assessment of long-term physiologic and behavioral changes associated with COVID-19 infection. JAMA Network Open. 2021; 4(7): e2115959. doi: 10.1001 / jamanetworkopen.2021.15959
Commentary
Autonomic dysfunction and cardiac damage after COVID-19 infection have been identified as long-term symptoms lasting up to 6 months, but they have not been quantified. This cohort study was designed to examine the duration and variability of recovery between COVID-19 positive and COVID-19 negative participants.
DETECT (Digital Engagement and Tracking for Early Control and Treatment) is an app-based, longitudinal research study of adult participants from across the United States that collects wearable data and relates to viral diseases, including COVID-19.
The study covered the period from March 25, 2020 to January 24, 2021, and enrolled 37,146 participants.
The analysis focused on 875 individuals who reported symptoms of acute respiratory illness and were found to be either positive (234 individuals) or negative (641 individuals) for COVID-19.
Results were compared in RHR, sleep, and activity from 234 COVID-19 positive individuals and 641 COVID-19 negative symptomatic individuals, with differences being most pronounced in RHR.
The COVID-19 positive individuals first experienced transient bradycardia, followed by prolonged relative tachycardia that did not return to baseline on average until 79 days after the onset of symptoms. Steps and sleep volume returned to baseline earlier than the RHR at 32 and 24 days, respectively.
During recovery, the positive participants experienced a different trajectory in the return of RHR to normal compared to the negative participants.
The long-term physiological effects of COVID-19 infection are expected to last about 2-3 months and may reflect various levels of dysfunction in the autonomic nervous system or ongoing inflammation. However, considerable intra-individual variability was observed. For transient bradycardia, we suggest that early symptoms and a larger initial RHR response to COVID-19 infection may be related to the physiological length of recovery from this virus.
