PhD Scientific Days 2022

Translational Medicine III.

Comprehensive Home Monitoring of Children with Long-COVID Syndrome - Case Presentation from an Ongoing Study

Text of the abstract

Introduction: Long-COVID syndrome might affect every fourth child after SARS-CoV-2 infection worldwide. Novel home monitoring opportunities might extend the data collection capabilities of the research teams which would optimally lead to faster and more accurate conclusions for the benefit of the patients.

Aims: This case study was obtained as a part of an ongoing research project to determine if adding a new home monitoring tool to the standard care of a pediatric long- COVID cohort would bring any benefit to the current protocols.

Methods: 16 year old female long-COVID patient with main complaints of fatigue,chest pain, stress dyspnoe at presentation was followed up for a month (27 home measurements in 30 days)
There were two outpatient clinic visits with long-COVID symptom questionnaire, blood pressure measurement, ECG and 6-minute-walking test before and after the home monitoring period. At home the subject was measuring herself with a commercially available pulseoximeter and peripheral pulsewave data was recorded anonymously for further mathematical analysis.

Result:. Symptom questionnaires and clinical tests have shown substantial improvement between in-person visits. This improvement is reflected in the trend changes of various pulsewave parameters. SpO2 and heart rate were stable and in the optimal range during the one month. Parameters showing increasing trends: parasympathetic activity markers (rMSSD, HF, HFnu), small and large artery function markers (stiffness index, ageing index). Parameters with decreasing trends: overall autonomic nervous system activity markers (SDNN, total power), sympathetic activity markers (LF, LFnu, LF/HF, HRV stress index).

Conclusion: The autonomic nervous system markers, derived from heart rate variability assessment showed a decrease in sympathetic overactivation and improvement in parasympathetic function.
Certain pulsewave derived cardiovascular parameters changed simultaneously with the subjective and objective improvement of the patient.
The change in cardiovascular markers might indicate that the vascular tone has increased during the monitoring period - despite the decreasing sympathetic autonomic tone.
This case study indicates the benefits of pulsewave monitoring in long-covid patients which will be determined upon the finalization of the study.

Funding:
ÚNKP-21-3-II - NKFIH