ABSTRACT
Long coronavirus disease (COVID) is emerging as a common clinical entity in the current era. Autonomic dysfunction is one of the frequently reported post-COVID complications. We hypothesize a bi-directional relationship between the autonomic function and the COVID course. This postulation has been inadequately addressed in the literature. A retrospective cohort (pre and post-comparison) study was conducted on 30 young adults whose pre-COVID autonomic function test results were available. They were divided into case and control groups based on whether they tested reverse transcription polymerase chain reaction positive for COVID-19. Autonomic function tests were performed in both the case and control groups. COVID infection in healthy young adults shifts the sympatho-vagal balance from the pre-disease state. Postural orthostatic tachycardia syndrome was present in 35% of the COVID-affected group. COVID course parameters were found to be associated with parasympathetic reactivity and the baroreflex function. Baseline autonomic function (parasympathetic reactivity represented by Δ heart rate changes during deep breathing and 30:15 ratio during lying-to-standing test) was also associated with the COVID course, the post-COVID symptoms and the post-COVID autonomic function profile. Additionally, multiple regression analysis found that the baseline parasympathetic reactivity was a very important determinant of the clinical course of COVID, the post-COVID symptoms and the post-COVID autonomic profile. Sympatho-vagal balance shifts to parasympathetic withdrawal with sympathetic predominance due to COVID infection in healthy young adults. There is a bi-directional relationship between the autonomic function and the COVID course.
Subject(s)
COVID-19 , Pandemics , Humans , Young Adult , Retrospective Studies , Heart Rate/physiology , Autonomic Nervous SystemABSTRACT
OBJECTIVE: COVID19 outbreak has put a tremendous physical and mental burden on frontline doctors. A limited amount of literature is available in this area. The present study was done to assess the depressive symptoms and depression levels in doctors working at COVID-19 Hospitals. METHOD: This study was based on an online survey that was started on May 2020 and ended on 30th June, 2020. An online questionnaire which included details such as age, gender, and 21 items to assess depressive symptoms was sent through social media to doctors from various countries. Depressive symptoms were measured by Beck's Depression Inventory-II (BDI-II). Items of a total of 220 questionnaires were responded. Out of these, only 200 responses were analyzed using SPSS software. RESULTS: Out of 200 subjects, 110 (55%) had depressive symptoms and 90 (45%) had no symptoms. Males had more depressive symptoms (42.5%) than females (12.5%). Those who worked at COVID-19 centers 75 (37.5%) had higher depressive symptoms. The number of males working at COVID-19 centers was much higher (36%) than females (12%). Depressive symptoms were significantly higher in males than females (35.35±10.25 vs 16.90±7.76; p<0.0001). CONCLUSION: Doctors, especially males working at COVID-19 centers have higher depressive symptoms than their female colleagues.Multicentric studies with larger sample sizes are needed to study the impact of COVID-19 on frontline doctors.