A model-based spectral directional approach reveals the long-term impact of COVID-19 on cardiorespiratory control and baroreflex
Abstract Background Coronavirus disease 19 (COVID-19) patients might develop sequelae after apparent resolution of the infection. Autonomic dysfunction and baroreflex failure have been frequently reported. However, the long-term effect of COVID-19 on cardiorespiratory and cardiovascular neural contr...
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BMC
2025-02-01
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| Series: | BioMedical Engineering OnLine |
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| Online Access: | https://doi.org/10.1186/s12938-024-01327-8 |
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| author | Beatrice Cairo Francesca Gelpi Vlasta Bari Martina Anguissola Pavandeep Singh Beatrice De Maria Marco Ranucci Alberto Porta |
| author_facet | Beatrice Cairo Francesca Gelpi Vlasta Bari Martina Anguissola Pavandeep Singh Beatrice De Maria Marco Ranucci Alberto Porta |
| author_sort | Beatrice Cairo |
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| description | Abstract Background Coronavirus disease 19 (COVID-19) patients might develop sequelae after apparent resolution of the infection. Autonomic dysfunction and baroreflex failure have been frequently reported. However, the long-term effect of COVID-19 on cardiorespiratory and cardiovascular neural controls has not been investigated with directional approaches able to open the closed-loop relationship between physiological variables. Methods A model-based causal spectral approach, namely causal squared coherence (CK2), was applied to the beat-to-beat variability series of heart period (HP) and systolic arterial pressure (SAP), and to the respiratory signal (RESP) acquired at rest in supine position and during active standing (STAND) in COVID-19 survivors 9 months after their hospital discharge. Patients were categorized according to their need of ventilatory support during hospitalization as individuals that had no need of continuous positive airway pressure (noCPAP, n = 27), need of continuous positive airway pressure in sub-intensive care unit (CPAP, n = 14) and need of invasive mechanical ventilation in intensive care unit (IMV, n = 8). Results The expected decrease of the strength of the HP-RESP dynamic interactions as well as the expected increase of the dependence of HP on SAP along baroreflex during STAND was not observed and this result held regardless of the severity of the disease, namely in noCPAP, CPAP and IMV cohorts. Regardless of the experimental condition, spectral causality markers did not vary across groups either. Conclusions CK2 markers, in association with an orthostatic challenge, were able to characterize the impairment of cardiorespiratory control and baroreflex in COVID-19 patients long after acute infection resolution and could be exploited to monitor the evolution of the COVID-19 patients after hospital discharge. |
| format | Article |
| id | doaj-art-f2e6ed4030d64d7ba642d50a9adda1a3 |
| institution | Kabale University |
| issn | 1475-925X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BioMedical Engineering OnLine |
| spelling | doaj-art-f2e6ed4030d64d7ba642d50a9adda1a32025-02-09T12:47:33ZengBMCBioMedical Engineering OnLine1475-925X2025-02-0124111810.1186/s12938-024-01327-8A model-based spectral directional approach reveals the long-term impact of COVID-19 on cardiorespiratory control and baroreflexBeatrice Cairo0Francesca Gelpi1Vlasta Bari2Martina Anguissola3Pavandeep Singh4Beatrice De Maria5Marco Ranucci6Alberto Porta7Department of Biomedical Sciences for Health, University of MilanDepartment of Biomedical Sciences for Health, University of MilanDepartment of Biomedical Sciences for Health, University of MilanDepartment of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San DonatoDepartment of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San DonatoIRCCS Istituti Clinici Scientifici MaugeriDepartment of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San DonatoDepartment of Biomedical Sciences for Health, University of MilanAbstract Background Coronavirus disease 19 (COVID-19) patients might develop sequelae after apparent resolution of the infection. Autonomic dysfunction and baroreflex failure have been frequently reported. However, the long-term effect of COVID-19 on cardiorespiratory and cardiovascular neural controls has not been investigated with directional approaches able to open the closed-loop relationship between physiological variables. Methods A model-based causal spectral approach, namely causal squared coherence (CK2), was applied to the beat-to-beat variability series of heart period (HP) and systolic arterial pressure (SAP), and to the respiratory signal (RESP) acquired at rest in supine position and during active standing (STAND) in COVID-19 survivors 9 months after their hospital discharge. Patients were categorized according to their need of ventilatory support during hospitalization as individuals that had no need of continuous positive airway pressure (noCPAP, n = 27), need of continuous positive airway pressure in sub-intensive care unit (CPAP, n = 14) and need of invasive mechanical ventilation in intensive care unit (IMV, n = 8). Results The expected decrease of the strength of the HP-RESP dynamic interactions as well as the expected increase of the dependence of HP on SAP along baroreflex during STAND was not observed and this result held regardless of the severity of the disease, namely in noCPAP, CPAP and IMV cohorts. Regardless of the experimental condition, spectral causality markers did not vary across groups either. Conclusions CK2 markers, in association with an orthostatic challenge, were able to characterize the impairment of cardiorespiratory control and baroreflex in COVID-19 patients long after acute infection resolution and could be exploited to monitor the evolution of the COVID-19 patients after hospital discharge.https://doi.org/10.1186/s12938-024-01327-8SARS-CoV-2Heart rate variabilityCardiorespiratory couplingCausalityClosed-loop cardiovascular interactionsAutonomic nervous system |
| spellingShingle | Beatrice Cairo Francesca Gelpi Vlasta Bari Martina Anguissola Pavandeep Singh Beatrice De Maria Marco Ranucci Alberto Porta A model-based spectral directional approach reveals the long-term impact of COVID-19 on cardiorespiratory control and baroreflex BioMedical Engineering OnLine SARS-CoV-2 Heart rate variability Cardiorespiratory coupling Causality Closed-loop cardiovascular interactions Autonomic nervous system |
| title | A model-based spectral directional approach reveals the long-term impact of COVID-19 on cardiorespiratory control and baroreflex |
| title_full | A model-based spectral directional approach reveals the long-term impact of COVID-19 on cardiorespiratory control and baroreflex |
| title_fullStr | A model-based spectral directional approach reveals the long-term impact of COVID-19 on cardiorespiratory control and baroreflex |
| title_full_unstemmed | A model-based spectral directional approach reveals the long-term impact of COVID-19 on cardiorespiratory control and baroreflex |
| title_short | A model-based spectral directional approach reveals the long-term impact of COVID-19 on cardiorespiratory control and baroreflex |
| title_sort | model based spectral directional approach reveals the long term impact of covid 19 on cardiorespiratory control and baroreflex |
| topic | SARS-CoV-2 Heart rate variability Cardiorespiratory coupling Causality Closed-loop cardiovascular interactions Autonomic nervous system |
| url | https://doi.org/10.1186/s12938-024-01327-8 |
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