Abstract

Background: Cardiac autonomic dysfunction (AD) may be a sequelae of infection with SARS-CoV-2;however, the risk factors for this condition are unknown. Objective: To explore the clinical characteristics and risk factors of patients with AD after SARS-CoV-2 infection. Methods: A retrospective cohort analysis was performed on SARS-CoV-2 positive patients with AD at Columbia University Medical Center and Kansas City Heart Rhythm Institute. Patients with a history of positive SARS-CoV-2 RT-PCR test, symptoms of palpitations and who were found to have unexplained sinus tachycardia were included. Columbia University IRB approved this study. Results: 14 patients were studied (age 18-69 years, 79% women). 21.4% had preexisting heart conditions, hypertension or hyperlipidemia. Patients presented with unexplained sinus tachycardia on 24-hr Holter or 1-2 week event monitor, an average of 38.4 days after testing positive for SARS-CoV-2. There was an average time of 94.6 days between patients first and most recent cardiology clinic visits. Common symptoms included palpations (64.2%), chest pressure (42.9%), headache, and fatigue (42.9%). Mean LVEF was 57.1±4.9%, with average HR range of 53.6 to 146.1 beats per minute. All patients had normal white blood cell count and thyroid levels. 23.1% patients demonstrated postural hypotension. 50% of patients were on ongoing beta-blocker use at the time of their last visit. Conclusion: In this small cohort of patients diagnosed with AD post-SARS-CoV-2 infection, majority were women and few had preexisting conditions. Further follow up is necessary to assess efficacy of therapeutics, length of treatment, and time till recovery.

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