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Title:: Evaluation and monitoring of cardiopulmonary function in patients with COVID-19 by dynamic heart rate analysis

作者:: 仲月霞1; 李沛2; 张楠3; 刁小飞4; 陈瑞娟4; 王慧泉4; 王新5△; 1.空军军医大学第二附属医院门诊部，西安710000；2.空军军医大学第二附属医院传染科，西安710000；3.空军军医大学第一附属医院骨科，西安710000；4.天津工业大学生命科学学院，天津300387；5.空军军医大学唐都医院，西安710000

Author(s):: ZHONG Yuexia1; LI Pei2; ZHANG Nan3; DIAO Xiaofei4; CHEN Ruijuan4; WANG Huiquan4; WANG Xin5; 1.Department of Outpatient, Second Affiliated Hospital of Fourth Military Medical University, Xi′an 710000, China;2.Department of Infection, Second Affiliated Hospital of Fourth Military Medical University, Xi′an 710000;3.Department of Orthopedics, First Affiliated Hospital of Fourth Military Medical University, Xi′an 710000;4.School of Life Sciences, Tiangong University, Tianjin 300387, China;5.Medical Aid Team of Tangdu Hospital, Fourth Military Medical University, Xi′an 710000

Keywords:: COVID-19; Heart rate variability ; Inflammation; Monitor; Assessment

摘要:: 有研究指出，新型冠状病毒患者易出现不同程度的心肌损伤，且新型冠状病毒肺炎（COVID-19）重症化可能与“炎症风暴”有密切关系。观察COVID-19患者心率及心率变异性（heart rate variability, HRV）的变化，以及肺部CT与白介素6指标之间的关系，为衡量COVID-19病情程度提供参考。应用远程无线动态心电监测系统，对COVID-19患者卧床、6 min运动状态心电进行动态监测，分析其心率变异性与肺部CT病变面积之间的关系。通过单因素方差分析法统计分析，平均心率HR在不同炎症程度下存在差异，具有统计学意义(P<0.05)，同时，HRV的时域、频域参数随着炎症程度的加深，产生了递增或递减趋势的变化，其中患者的RMSSD、pNN50不断降低，LFn/HFn、LFn和HFn也具有明显的变化。通过观测这些HRV参数的变化，对临床上COVID-19患者的评估预警和规避风险具有重要的参考价值。

Abstract:: Studies have shown that COVID-19 patients are prone to different degrees of myocardial damage, and the severe COVID-19 pneumonia may be closely related to “inflammatory storm”. We observed the changes in heart rate and heart rate variability (HRV) of COVID-19 patients, as well as the relationship between lung CT and interleukin 6 indicators to provide a reference for measuring the severity of COVID-19.In order to analyze the relationship between heart rate variability (HRV) and lung CT lesion area, a long-distance wireless ambulatory ECG monitoring system was used to monitor the ECG of hospitalized COVID-19 patients in bed and 6 min of exercise. Results through single factor variance analysis, there were significant differences in average heart rate (HR) under different degrees of inflammation (P<0.05). The time and frequency domain parameters of HRV showed an increase or decrease trend with the deepening of inflammation. RMSSD, pNN50 decreased continuously, LFN / HFN, LFN and HFN also changed significantly. By observing the changes of these HRV parameters, it has important reference value for the clinical early warning and risk avoidance of patients with new coronavirus inflammation.