The contribution of psychological distress to resting palpitations in
patients recovering from severe coronavirus disease 2019
Abstract
Background: Increasing numbers of patients have recovered from severe
coronavirus disease 2019 (COVID-19) in Wuhan, China. This study aimed to
evaluate the association of psychological distress with resting
palpitations in those recovered patients. Methods: In this prospective
cohort study, consecutive patients who recovered from severe COVID-19
and complained of resting palpitations were included. Dynamic
electrocardiogram (ECG) was continuously monitored for 2 hours while
patients were at rest. A survey using palpitation frequency scale and
the Hospital Anxiety and Depression Scale (HADS) was administrated to
all participants. Results: Of the 289 consecutive patients recovering
from severe COVID-19, 24 patients (8.3%) suffered resting palpitations
symptoms, and 22 patients were finally included. Dynamic ECG monitoring
showed that 18 (81.8%) patients had tachyarrhythmias, of which, the
most common was sinus tachycardia (17/22, 77.3%). However, patients
with sinus tachycardia showed a similar frequency of palpitations
episodes compared to those without sinus tachycardia. Anxiety (68.2%)
and depression (59.1%) were prevalent among these recovered patients.
Patients with anxiety or depression symptoms were respectively
associated with a higher frequency of palpitations episodes than those
without. In addition, both HADS-anxiety score (r =0.609,
P<0.01) and HADS-depression score (r =0.516, P=0.01) were
positively related to the frequency of palpitations episodes,
respectively. Conclusion: Symptom of resting palpitations, manifested
mainly by sinus tachycardia, is not uncommon in patients recovering from
severe COVID-19. Psychological distress (anxiety and depression) may be
responsible, at least in part, for the resting palpitations symptoms.