Heart rate variability biofeedback in Long COVID (HEARTLOC)

Joanna Corrado, Alexander J. Casson, Stephen J. Halpin, Rory J O'Connor, Manoj Sivan

Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review


Introduction: Long COVID (LC) refers to symptoms persisting 12 weeks after SARS-COV-2 infection. It affects over 50 million people worldwide, causing varied symptoms including fatigue, breathlessness and palpitations Many of these symptoms can be linked to autonomic nervous system dysregulation (dysautonomia). This proof-of-concept study tests feasibility, and estimates efficacy, of a heart rate variability biofeedback (HRV-B) intervention using a standardised diaphragmatic breathing technique in LC patients.
Methods and Analysis: 30 adult LC patients with symptoms of palpitations or dizziness and abnormal NASA Lean Test (NLT) are recruited from a UK COVID-19 rehabilitation service. They undertake an active 4-week HRV-B intervention using a chest strap linked to a HRV phone application while undertaking the breathing technique for 10-min twice daily. Quantitative data including HRV are gathered during the study period using Fitbit, the modified COVID-19 Yorkshire Rehabilitation Scale (C19-YRSm), Composite Autonomic Symptom Score (COMPASS 31), World Health Organisation Disability Assessment Schedule (WHODAS 2.0) and EQ-5D-5L health related quality of life measure. Quantitative data will be analysed using standard statistical tests.
Results: This study is ongoing; we have preliminary data for 3 completed participants. They demonstrated mean improvement of 3.7 points (from 16.7 pre-intervention to 13 post-intervention) on C19-YRS symptom severity scale, 1.3 (from 5.3 to 4.0) on C19-YRS functional scale, and 0.6 (from 4.7 to 5.3) on C19-YRS overall health score. Average autonomic score improved by 9.6 (from 47.0 to 37.4). Mean WHODAS score improvement was 4.3 (from 28.5 to 24.2) There was improvement in HRV score and reduction in resting heart rate. Further data will be presented at conference.
Conclusion: These preliminary data demonstrate that HRV-B can improve LC symptoms, autonomic symptoms, reduce disability and improve HRV.
Original languageEnglish
Title of host publication7th Baltic and North Sea Conference on Physical and Rehabilitation Medicine
Publication statusAccepted/In press - 2 May 2022


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