# Long-Term Electrocardiographic Changes in Healthcare Workers Following Mild to Moderate Cases of Coronavirus (COVID-19): A Longitudinal Observational Study

## TL;DR

This study found that mild to moderate COVID-19 in healthcare workers caused temporary heart rate changes and minor ECG changes, likely due to autonomic effects, with no long-term risks.

## Contribution

The study provides new longitudinal ECG data on mild to moderate SARS-CoV-2 cases in healthcare workers, revealing transient autonomic effects.

## Key findings

- Heart rate increased temporarily at 6–12 months post-infection but normalized after 12 months.
- PR interval shortening was mild and persistent at both 6–12 and >12 months post-infection.
- ECG changes were not linked to sex or age, except for greater PR shortening in males.

## Abstract

Background: The cardiovascular effects of SARS-CoV-2, including autonomic dysregulation, are becoming increasingly recognized, even following mild infections. However, long-term electrocardiographic (ECG) changes remain poorly characterized. Methods: We conducted a prospective study of 151 unvaccinated healthcare workers with RT-PCR-confirmed mild to moderate SARS-CoV-2 infection. Standard 12-lead ECGs were recorded before infection (T0) and at 6–12 months (T1) and >12 months (T2) after infection. Key parameters included heart rate (HR), PR interval, QRS duration, and corrected QT interval (QTc). Results: Heart rate (HR) increased transiently at T1 (p < 0.05) and normalized by T2. Mild but persistent PR interval shortening was observed at both follow-ups (p < 0.01). There were no significant changes in QRS or QTc intervals. No arrhythmias or conduction blocks occurred. ECG alterations were not associated with sex or age, except for greater PR shortening in males. Conclusions: Mild SARS-CoV-2 infection can result in transient sinus tachycardia and subtle PR shortening, which is likely to be a post-viral autonomic effect. Long-term ECG surveillance appears unnecessary in asymptomatic cases.