Interrelation of plasma haemostasis and heart rate variability in patients with chronic coronary syndrome in combination with COVID-19
DOI:
https://doi.org/10.61751/bmbr/3.2024.40Keywords:
activated partial thromboplastin time, prothrombin time, fibrinogen, D-dimer, N-N interval, parasympatheticsympathetic activityAbstract
The aim of the study was to identify the relationship between activated partial thromboplastin time,
prothrombin time, fibrinogen, D-dimer and indicators of N-N interval deviations, heart rate, on the one hand, and to
identify the relationship between parasympathetic and sympathetic heart rate activity and dynamic blood viscosity,
on the other hand. The COVID-19 pathogen affects the functioning of the parasympathetic and sympathetic nervous
systems, which also changes the heart rate. To study this process, a group of 10 patients with chronic coronary syndrome
in combination with COVID-19 without comorbidities aged 35-48 years was observed in a hospital. To study this
relationship, plasma haemostasis parameters (activated partial thromboplastin time, prothrombin time, fibrinogen,
D-dimer) and heart rate variability were taken at the time of admission to the hospital and after discharge from the
hospital. A direct correlation between the indicators was found: in patients 1 and 4, at the time of admission to the
hospital, there was an increase in activated partial thromboplastin time, prothrombin time, D-dimer and a decrease in
fibrinogen, which coincides with an increase in heart rate, 5-10 minute and long-term deviation of the N-N segments.
That is, changes in blood plasma affect the rhythm of the heart already at the onset of COVID-19 in combination with
chronic coronary syndrome. Patients 1 and 4 had an increase in D-dimer at the time of discharge from the hospital,
which coincided with an increase in heart rate. Patients require further follow-up, as these are signs of a cautious
prognosis. All other plasma haemostasis parameters are normal in all patients, with minor changes. It is necessary
to monitor plasma haemostasis and heart rate variability to adjust treatment during hospitalization of patients with
chronic coronary syndrome in combination with COVID-19 and after discharge from hospital
Received: 08.05.2024 | Revised: 15.07.2024 | Accepted: 30.08.2024
References
Golubovska O. Post-COVID syndrome: Pathogenesis and main directions of rehabilitation [Internet]. Health Ukr. 2021;2(495):16–18.
Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F, et al. Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in COVID-19. N Engl J Med. 2020;383(2):120–28. DOI: 10.1056/NEJMoa2015432
Chen C, Zhou Y, Wang DW. SARS-CoV-2: A potential novel etiology of fulminant myocarditis. Herz. 2020;45(3):230–32. DOI: 10.1007/s00059-020-04909-z
Chen L, Li X, Chen M, Feng Y, Xiong C. The ACE2 expression in human heart indicates new potential mechanism of heart injury among patients infected with SARS-CoV-2. Cardiovasc Res. 2020;116(6):1097–10. DOI: 10.1093/cvr/cvaa078
Chung M, Bernheim A, Mei X, Zhang N, Huang M, Zeng X, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology. 2020;295(1):202–7. DOI: 10.1148/radiol.2020200230
Driggin E, Madhavan MV, Bikdeli B, Chuich T, Laracy J, Biondi-Zoccai G, et al. Cardiovascular considerations for patients, health care workers, and health systems during the COVID-19 pandemic. J Am Coll Cardiol. 2020;75(18):2352–71. DOI: 10.1016/j.jacc.2020.03.031
Esmel-Vilomara R, Dolader P, Sabaté-Rotes A, Soriano-Arandes A, Gran F, Rosés-Noguer F. QTc interval prolongation in patients infected with SARS-CoV-2 and treated with antiviral drugs. An Pediatr (Engl Ed). 2022;96(3):213–20. DOI: 10.1016/j.anpede.2021.04.006
Fang SC, Wu YL, Tsai PS. Heart rate variability and risk of all-cause death and cardiovascular events in patients with cardiovascular disease: A meta-analysis of cohort studies. Biol Res Nurs. 2020;22(1):45–56. DOI: 10.1177/1099800419877442
Varga Z, Flammer AJ, Steiger P, Haberecker M, Andermatt R, Zinkernagel AS, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395(10234):1417–18. DOI: 10.1016/S0140-6736(20)30937-5
Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020;181(2):271–80. DOI: 10.1016/j.cell.2020.02.052
Vaduganathan M, Vardeny O, Michel T, McMurray JJV, Pfeffer MA, Solomon SD. Renin-angiotensin-aldosterone system inhibitors in patients with COVID-19. N Engl J Med. 2020;382(17):1653–59. DOI: 10.1056/NEJMsr2005760
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061–69. DOI: 10.1001/jama.2020.1585
Stefanini GG, Montorfano M, Trabattoni D, Andreini D, Ferrante G, Ancona M, et al. ST-elevation myocardial infarction in patients with COVID-19: Clinical and angiographic outcomes. Circulation. 2020;141(25):2113–16. DOI: 10.1161/CIRCULATIONAHA.120.047525
Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844–47. DOI: 10.1111/jth.14768
Gao YD, Ding M, Dong X, Zhang JJ, Kursat Azkur A, Azkur D, et al. Risk factors for severe and critically ill COVID-19 patients: A review. Allergy. 2021;76(2):428–55. DOI: 10.1111/all.14657
Grégoire JM, Gilon C, Carlier S, Bersini H. Autonomic nervous system assessment using heart rate variability. Acta Cardiol. 2023;78(6):648–62. DOI: 10.1080/00015385.2023.2177371
Lundstrom K, Hromić-Jahjefendić A, Bilajac E, Aljabali AAA, Baralić K, Sabri NA, et al. COVID-19 signalome: Pathways for SARS-CoV-2 infection and impact on COVID-19 associated comorbidity. Cell Signal. 2023;101:110495. DOI: 10.1016/j.cellsig.2022.110495
Mandal S, Barnett J, Brill SE, Brown JS, Denneny EK, Hare SS, et al. ‘Long-COVID’: A cross-sectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalisation for COVID-19. Thorax. 2021;76(4):396–98. DOI: 10.1136/thoraxjnl-2020-215818
Minguito-Carazo C, Echarte-Morales J, Benito-González T, Del Castillo-García S, Rodríguez-Santamarta M, Sánchez-Muñoz E, et al. QT interval monitoring with handheld heart rhythm ECG device in COVID-19 patients. Glob Heart. 2021;16(1):42. DOI: 10.5334/gh.916
Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475–81. DOI: 10.1016/S2213-2600(20)30079-5
He XW, Lai JS, Cheng J, Wang MW, Liu YJ, Xiao ZC, et al. Impact of complicated myocardial injury on the clinical outcome of severe or critically ill COVID-19 patients. Zhonghua Xin Xue Guan Bing Za Zhi. 2020;48(6):456–60. DOI: 10.3760/cma.j.cn112148-20200228-00137
Zheng YY, Ma YT, Zhang JY, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol. 2020;17(5):259–60. DOI: 10.1038/s41569-020-0360-5
Harrison SL, Buckley BJR, Rivera-Caravaca JM, Zhang J, Lip GYH. Cardiovascular risk factors, cardiovascular disease, and COVID-19: An umbrella review of systematic reviews. Eur Heart J Qual Care Clin Outcomes. 2021;7(4):330–39. DOI: 10.1093/ehjqcco/qcab029
Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021;42(5):373–98. DOI: 10.1093/eurheartj/ehaa612
Husain Q, Kokinakos K, Kuo YH, Zaidi F, Houston S, Shargorodsky J. Characteristics of COVID-19 smell and taste dysfunction in hospitalized patients. Am J Otolaryngol. 2021;42(6):103068. DOI: 10.1016/j.amjoto.2021.103068
The World Medical Association. Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects [Internet]. [cited 2024 Jul 25]. Available from: https://www.wma.net/what-we-do/medical-ethics/ declaration-of-helsinki/
Parohan M, Yaghoubi S, Seraji A, Javanbakht MH, Sarraf P, Djalali M. Risk factors for mortality in patients with Coronavirus disease 2019 (COVID-19) infection: A systematic review and meta-analysis of observational studies. Aging Male. 2020;23(5):1416–24. DOI: 10.1080/13685538.2020.1774748
Rabaan AA, Smajlović S, Tombuloglu H, Ćordić S, Hajdarević A, Kudić N, Al Mutai A, Turkistani SA, Al-Ahmed SH, Al-Zaki NA, Al Marshood MJ, Alfaraj AH, Alhumaid S, Al-Suhaimi E. SARS-CoV-2 infection and multi-organ system damage: A review. Biomol Biomed. 2023;23(1):37–52. DOI: 10.17305/bjbms.2022.7762
Silverio A, Di Maio M, Citro R, Esposito L, Iuliano G, Bellino M, et al. Cardiovascular risk factors and mortality in hospitalized patients with COVID-19: systematic review and meta-analysis of 45 studies and 18,300 patients. BMC Cardiovasc Disord. 2021;21(1):23. DOI: 10.1186/s12872-020-01816-3
Bangalore S, Sharma A, Slotwiner A, Yatskar L, Harari R, Shah B, et al. ST-segment elevation in patients with Covid-19 – A case series. N Engl J Med. 2020;382(25):2478–80. DOI: 10.1056/NEJMc2009020
Keski H. Hematological and inflammatory parameters to predict the prognosis in COVID-19. Indian J Hematol Blood Transfus. 2021;37:534–42. DOI: 10.1007/s12288-021-01407-y
Colantuoni A, Martini R, Caprari P, Ballestri M, Capecchi PL, Gnasso A, et al. COVID-19 sepsis and microcirculation dysfunction. Front Physiol. 2020;11:747. DOI: 10.3389/fphys.2020.00747
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Bulletin of Medical and Biological Research

This work is licensed under a Creative Commons Attribution 4.0 International License.











