Autonomic Dysfunction Related to Postacute SARS-CoV-2 Syndrome

Haloot, Justin; Bhavaraju‐Sanka, Ratna; Pillarisetti, Jayasree; Verduzco‐Gutierrez, Monica

doi:10.1016/j.pmr.2023.04.003

Cited by 8 publications

(4 citation statements)

References 61 publications

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“…Therefore, the results suggest that recovery from severe COVID-19 may cause a permanent abnormal P-wave axis (Table 3). These findings can be attributed to the medical and invasive interventions in the treatment algorithm of severe COVID-19 patients, as well as to the nature of the SARS-CoV-2 virus, which is known to damage the myocardium and ANS during acute illness [13][14][15][16][17][18][19][20][21][22][23][24]39].…”

Section: Discussionmentioning

confidence: 99%

Recovery from Severe COVID-19 Is an Independent Predictor of Electrocardiographic Abnormal P-Wave Axis

Yılmaz,

Mirzaoğlu

2024

Diagnostics

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Aim: Abnormal P-wave axis (aPwa) have been correlated with an increased risk of supraventricular arrhythmias. The aim of this study was to analyze whether infection with COVID-19 may cause a predisposition for supraventricular arrhythmia in the long term, following recovery. Materials and Methods: In this study, a total of 252 subjects with a confirmed history of COVID-19 (recovered COVID-19) and 251 healthy subjects without a history of COVID-19 were included. The recovered COVID-19 group was divided into three subgroups designated as mild, moderate, and severe according to the severity score of their chest CT. The aPwa data were obtained using 12-lead electrocardiography (ECG) and compared between the healthy subjects and the recovered COVID-19 subgroups. Results: This study showed that in the recovered severe COVID-19 subgroup the prevalence of aPwa was significantly increased compared to the controls and the other COVID-19 subgroups. No correlation could be detected in Spearman’s Rho correlation between the existence of aPwa and the number of positive PCR tests for COVID-19 and the time elapsed after infection with COVID-19. The binary logistic regression analysis showed that recovery from severe COVID-19, the severity score of the chest CT in the recovered from COVID-19 subjects, and the existence of hypertension (HT) were all independent predictors of aPwa (hazard ratio: 3.542, 95% confidence interval: 1.398–8.969, p: 0.01; hazard ratio: 0.896, 95% confidence interval: 0.840–0.955, p < 0.001; hazard ratio: 2.710, 95% confidence interval: 1.079–6.804, p: 0.03, respectively). Conclusions: Individuals who have recovered from severe COVID-19 have shown an increased prevalence of aPwa. The existence of aPwa was not associated with the number of positive PCR tests for COVID-19 or the time elapsed after infection with COVID-19. Therefore, recovery from severe COVID-19 is an independent predictor of electrocardiographic abnormal P-wave axis.

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Section: Discussionmentioning

confidence: 99%

Recovery from Severe COVID-19 Is an Independent Predictor of Electrocardiographic Abnormal P-Wave Axis

Yılmaz,

Mirzaoğlu

2024

Diagnostics

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“…5 Orthostatic intolerance and postural orthostatic tachycardia syndrome (POTS) can commonly follow acute viral infections, and are similarly observed in up to 80% of people with Long COVID. [5][6][7][8] Prior to the COVID-19 pandemic, approximately 50% of individuals with POTS reported a history of viral infection prior to symptom onset, suggesting this as a potential trigger. 9 The presence of autonomic dysfunction in Long COVID is possibly due to mechanisms such as viral-or immune-mediated disruption of the autonomic nervous system, 10 brainstem signaling abnormalities, 11 and/or small fiber neuropathy.…”

Section: Introductionmentioning

confidence: 99%

Resonant breathing improves self-reported symptoms and wellbeing in people with Long COVID

Polizzi,

Tosto-Mancuso,

Tabacof

et al. 2024

Preprint

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Introduction: Long COVID involves debilitating symptoms, many of which mirror those observed with dysautonomia, and care must be taken with traditional autonomic rehabilitation to avoid post-exertional malaise/post-exertional symptom exacerbation. Resonant breathing exercises require less exertion and can potentially improve autonomic function. The objective of this work was to report on the impact of a resonant breathing program on self-reported symptoms and wellbeing in people with Long COVID. Methods: A retrospective analysis of de-identified data was completed in a convenience sample of people with Long Covid, who participated in the Meo Health (formerly known as Stasis HP) resonant breathing program. Participants completed baseline and follow up surveys. Results: Data were available for 99 participants. Most measures of symptoms and wellbeing improved at follow up, with the largest differences per participant seen in sense of wellness (47.3%, p<0.0001), ability to focus (57.5%, p<0.0001), ability to breathe (47.5%, p<0.0001), ability to control stress (61.8%, p<0.0001) and sleep quality (34.9%, p=0.0002). Most (92%) participants reported improvement at follow up on the Patient Global Impression of Change Scale. Conclusion: Self-reported symptoms and wellbeing improved in people with Long COVID completing resonant breathing. Resonant breathing can be considered as an option within the broader treatment plan of people with Long COVID.

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“…Other symptoms include postactivity polypnea, sweating abnormalities, nausea or vomiting, chest pains or discomfort, increased resting heart rate (HR), sleep disorders, flushing, and dizziness. 8 Haloot et al 9 reported on the association between each symptom of long COVID and autonomic dysfunction. The mechanisms of autonomic dysfunction after COVID-19 infection are considered multifactorial, and one of the main mechanisms is because of the direct effects of the virus.…”

Section: Introductionmentioning

confidence: 99%

“…Haloot et al. 9 reported on the association between each symptom of long COVID and autonomic dysfunction. The mechanisms of autonomic dysfunction after COVID‐19 infection are considered multifactorial, and one of the main mechanisms is because of the direct effects of the virus.…”

Section: Introductionmentioning

confidence: 99%

Treatment of long COVID complicated by postural orthostatic tachycardia syndrome—Case series research

Tsuchida,

Ishibashi,

Inoue

et al. 2023

J of Gen and Family Med

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BackgroundCoronavirus disease 2019 (COVID‐19) sequelae, also known as long COVID, can present with various symptoms. Among these symptoms, autonomic dysregulation, particularly postural orthostatic tachycardia syndrome (POTS), should be evaluated. However, previous studies on the treatment of POTS complicated by COVID‐19 are lacking. Therefore, this study aimed to investigate the treatment course of long COVID complicated by POTS.MethodsThe medical records of patients who complained of fatigue and met the criteria for POTS diagnosis were reviewed. We evaluated the treatment days, methods and changes in fatigue score, changes in heart rate on the Schellong test, and social situation at the first and last visits.ResultsThirty‐two patients with long COVID complicated by POTS were followed up (16 males; median age: 28 years). The follow‐up period was 159 days, and the interval between COVID‐19 onset and initial hospital attendance was 97 days. Some patients responded to β‐blocker therapy. Many patients had psychiatric symptoms that required psychiatric intervention and selective serotonin reuptake inhibitor prescription. Changes in heart rate, performance status, and employment/education status improved from the first to the last visit. These outcomes were believed to be because of the effects of various treatment interventions and spontaneous improvements.ConclusionsOur study suggests that the condition of 94% of patients with POTS complicated by long COVID will improve within 159 days. Therefore, POTS evaluation should be considered when patients with long COVID complain of fatigue, and attention should be paid to psychological symptoms and the social context.

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Autonomic Dysfunction Related to Postacute SARS-CoV-2 Syndrome

Cited by 8 publications

References 61 publications

Recovery from Severe COVID-19 Is an Independent Predictor of Electrocardiographic Abnormal P-Wave Axis

Recovery from Severe COVID-19 Is an Independent Predictor of Electrocardiographic Abnormal P-Wave Axis

Resonant breathing improves self-reported symptoms and wellbeing in people with Long COVID

Treatment of long COVID complicated by postural orthostatic tachycardia syndrome—Case series research

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