Predictive and Prognostic Value of Heart Rate Variability Analysis in Early Bedside Diagnosis and Management of COVID-19 Patients

Viral infection, sepsis and multiple organ dysfunction are the most common causes of death in critically ill patients. Early diagnosis and early management are the key factor in improving outcome in sepsis due to viral infection, so, there is need to develop more rapid, sensitive, and specific diagnostic strategies that allow early intervention to improve patient outcome. Heart rate variability (HRV) has been documented to be both altered in the presence of systemic infection, and correlated with its severity. This aim of this article is to review the HRV analysis and its value in detection early diagnosis of viral infection including COVID-19 patients. The prognostic value of clinical bedside application of HRV in the management and treatment viral infection and sepsis are highlighted in this review. The overall HRV decreased with lower low frequency component has been shown to be consistently correlated with the presence and severity of viral infection. HRV monitoring may enhance the early diagnosis, prognosis and early initiation of treatment of viral infectionCOVID-19. Bedside wearable devices that are based on photoplethysmography such as watch-like devices and mobile phone apps may be used as a useful non-invasive tool for early diagnosis of COVID -19 by analyzing the HRV.