From the Guidelines
A persistently elevated heart rate after COVID-19 infection could be a sign of post-COVID syndrome or "long COVID," and it is essential to consult with a healthcare provider for proper evaluation and management. This condition, where symptoms persist for weeks or months after the initial infection, commonly includes tachycardia (elevated heart rate) [ 1 ]. The elevated heart rate may result from various factors, including autonomic nervous system dysfunction, inflammation affecting the heart, deconditioning during illness, or direct viral damage to heart tissue [ 1 ].
Possible Causes and Management
Some possible causes of elevated heart rate after COVID-19 infection include:
- Autonomic nervous system dysfunction
- Inflammation affecting the heart
- Deconditioning during illness
- Direct viral damage to heart tissue
- Anemia, thyroid issues, or heart damage [ 1 ]
Treatment options might include:
- Beta-blockers like metoprolol (starting at 25-50mg daily) to control heart rate
- Increased hydration (2-3 liters of water daily)
- A gradual return to physical activity through cardiac rehabilitation [ 1 ]
Importance of Medical Guidance
Many patients see improvement over time, but medical guidance is essential for proper management and to ensure there are no underlying complications requiring specific treatment [ 1 ]. It is crucial to consult with a healthcare provider to rule out other causes of elevated heart rate and to develop a personalized treatment plan.
Post-COVID Syndrome
Post-COVID syndrome, also known as "long COVID," is a condition where symptoms persist for weeks or months after the initial infection [ 1 ]. This condition can include a range of symptoms, including tachycardia, and can have a significant impact on a person's quality of life. It is essential to seek medical attention if symptoms persist or worsen over time.
From the Research
Elevated Heart Rate after COVID-19 Infection
The elevation of heart rate to tachycardia after contracting Coronavirus disease (COVID-19) in 2020 can be attributed to several factors. Some of the key points to consider include:
- Cardiovascular complications such as myocardial injury and arrhythmia are more likely to develop in patients with a more severe form of COVID-19 2.
- The true incidence of and mechanism underlying these events remain elusive, but emerging epidemiological evidence suggests that cardiovascular risk factors are associated with increased disease severity and mortality in COVID-19 patients 2.
- Multiple mechanisms, including the role of inflammation and IL-6, potentially underlie the cardiovascular complications associated with COVID-19, such as myocardial injury, thromboembolic events, arrhythmia, and heart failure 3.
- Cardiac arrhythmias, including tachycardia, have been reported in COVID-19 patients, with contributory factors ranging from direct viral myocardial injury to underlying inherited arrhythmia syndromes 3.
- Patients recovering from COVID-19 have an increased incidence of myocarditis and arrhythmias after recovery compared to control groups without COVID-19 4.
- Cardiovascular autonomic dysfunction (CVAD) is a common component of post-COVID-19 syndrome, affecting one-third of highly symptomatic patients, and can manifest as disorders associated with hypotension or tachycardia, such as postural orthostatic tachycardia syndrome and inappropriate sinus tachycardia 5.
- High heart rate at discharge in COVID-19 patients is not a frequent consequence but is strongly related to a severe course of the disease, with significant predictors including admission heart rate, haemoglobin, and severe disease 6.
Possible Mechanisms
Possible mechanisms underlying the elevation of heart rate after COVID-19 infection include:
- Direct viral invasion of cardiomyocytes with consequent unopposed effects of angiotensin II, increased metabolic demand, immune activation, or microvascular dysfunction 3.
- Endothelial dysfunction secondary to direct viral invasion or inflammation, leading to thromboembolic events and cardiovascular complications 3.
- Immune activation and inflammation, including the role of IL-6, contributing to cardiovascular complications and arrhythmias 3.
- Autonomic dysfunction, including CVAD, affecting heart rate and blood pressure control, and manifesting as disorders associated with hypotension or tachycardia 5.