Autonomic dysfunction following COVID-19 infection: an early experience

Autor: Michelle L. Mauermann, Eduardo E. Benarroch, Wolfgang Singer, William P. Cheshire, Kamal Shouman, Sarah E. Berini, Greg Vanichkachorn, Elizabeth A. Coon, Guillaume Lamotte, Phillip A. Low, Paola Sandroni, Mariana D. Suarez, Shahar Shelly, Jeremy K. Cutsforth-Gregory
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Adult
Male
medicine.medical_specialty
Orthostatic intolerance
Shy-Drager Syndrome
Autoimmune autonomic ganglionopathy
Autonomic diseases
030204 cardiovascular system & hematology
Dizziness
03 medical and health sciences
Orthostatic vital signs
Young Adult
0302 clinical medicine
Post-Acute COVID-19 Syndrome
Internal medicine
Postural Orthostatic Tachycardia Syndrome
Medicine
Humans
Vasovagal syncope
Aged
Retrospective Studies
Neurologic Examination
Endocrine and Autonomic Systems
business.industry
Hemodynamics
COVID-19
Postural orthostatic tachycardia syndrome
Middle Aged
medicine.disease
Inappropriate sinus tachycardia
Autonomic Nervous System Diseases
Cardiology
Autonomic Dysreflexia
Autonomic Fibers
Postganglionic
Autonomic dysreflexia
Female
Neurology (clinical)
business
030217 neurology & neurosurgery
Orthostatic headache
Research Article
Zdroj: Clinical Autonomic Research
ISSN: 1619-1560
0959-9851
Popis: Purpose Post-COVID-19 syndrome is a poorly understood aspect of the current pandemic, with clinical features that overlap with symptoms of autonomic/small fiber dysfunction. An early systematic analysis of autonomic dysfunction following COVID-19 is lacking and may provide initial insights into the spectrum of this condition. Methods We conducted a retrospective review of all patients with confirmed history of COVID-19 infection referred for autonomic testing for symptoms concerning for para-/postinfectious autonomic dysfunction at Mayo Clinic Rochester or Jacksonville between March 2020 and January 2021. Results We identified 27 patients fulfilling the search criteria. Symptoms developed between 0 and 122 days following the acute infection and included lightheadedness (93%), orthostatic headache (22%), syncope (11%), hyperhidrosis (11%), and burning pain (11%). Sudomotor function was abnormal in 36%, cardiovagal function in 27%, and cardiovascular adrenergic function in 7%. The most common clinical scenario was orthostatic symptoms without tachycardia or hypotension (41%); 22% of patients fulfilled the criteria for postural tachycardia syndrome (POTS), and 11% had borderline findings to support orthostatic intolerance. One patient each was diagnosed with autoimmune autonomic ganglionopathy, inappropriate sinus tachycardia, vasodepressor syncope, cough/vasovagal syncope, exacerbation of preexisting orthostatic hypotension, exacerbation of sensory and autonomic neuropathy, and exacerbation of small fiber neuropathy. Conclusion Abnormalities on autonomic testing were seen in the majority of patients but were mild in most cases. The most common finding was orthostatic intolerance, often without objective hemodynamic abnormalities on testing. Unmasking/exacerbation of preexisting conditions was seen. The temporal association between infection and autonomic symptoms implies a causal relationship, which however cannot be proven by this study.
Databáze: OpenAIRE
Externí odkaz: