ABSTRACT
Background: The spread of the COVID-19 virus presents an unprecedented event that rapidly introduced widespread life threat, economic destabilization, and social isolation. The human nervous system is tuned to detect safety and danger, integrating body and brain responses via the autonomic nervous system. Shifts in brain-body states toward danger responses can compromise mental health. For those who have experienced prior potentially traumatic events, the autonomic threat response system may be sensitive to new dangers and these threat responses may mediate the association between prior adversity and current mental health. Method: The present study collected survey data from adult U.S. residents (n = 1,666; 68% female; Age M = 46.24, SD = 15.14) recruited through websites, mailing lists, social media, and demographically-targeted sampling collected between March and May 2020. Participants reported on their adversity history, subjective experiences of autonomic reactivity, PTSD and depression symptoms, and intensity of worry related to the COVID-19 pandemic using a combination of standardized questionnaires and questions developed for the study. Formal mediation testing was conducted using path analysis and structural equation modeling. Results: Respondents with prior adversities reported higher levels of destabilized autonomic reactivity, PTSD and depression symptoms, and worry related to COVID-19. Autonomic reactivity mediated the relation between adversity and all mental health variables (standardized indirect effect range for unadjusted models: 0.212-0.340; covariate-adjusted model: 0.183-0.301). Discussion: The data highlight the important role of autonomic regulation as an intervening variable in mediating the impact of adversity on mental health. Because of the important role that autonomic function plays in the expression of mental health vulnerability, brain-body oriented therapies that promote threat response reduction should be investigated as possible therapeutic targets.
ABSTRACT
BACKGROUND: As the COVID-19 pandemic continues, determining hospital demands has become a vital priority. Heart rate variability (HRV) has been linked to both the presence of viral infection and its severity. We investigate the possibility of using HRV parameters in comparison to other clinical parameters for predicting the hospital length of stay (LOS) for COVID-19 patients. METHODS: This was a population-based cohort study. Measurements were performed in a specialized hospital for respiratory disease, dedicated to COVID-19. Patients were polymerase chain reaction positive for COVID-19 and on their 1st day of admission. Heart period, respiratory sinus arrhythmia (RSA), low frequency (LF) HRV, and vagal efficiency were calculated from electrocardiogram signals. This study investigated the correlation of HRV, demographic, and laboratory parameters with hospital LOS. RESULTS: Forty-one participants were recruited, with a significant relationship, observed between hospital LOS and some demographic and clinical parameters such as lymphocyte count, age, and oxygen saturation of arterial blood. There was a negative relationship between LF and hospital LOS (r = -0.53, 95% confidence interval: -0.73, -0.24). Higher vagal efficiency predicted shorter hospital LOS in patients younger than 40 years of age (19.27% shorter hospital LOS was associated with a one SD higher value of VE, P = 0.007). CONCLUSION: HRV measurement is a non-invasive, inexpensive, and scalable procedure that produces several metrics, some of which are useful for predicting hospital LOS and managing treatment resources during COVID-19 pandemic.