Cardiorespiratory dysautonomia in post‐COVID‐19 condition: Manifestations, mechanisms and management

Fedorowski, Artur; Olsén, Monika Fagevik; Nikesjö, Frida; Janson, Christer; Bruchfeld, Judith; Lerm, Maria; Hedman, Kristofer

doi:10.1111/joim.13652

Cited by 14 publications

(5 citation statements)

References 101 publications

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“…Patients with PASC and POTS should be educated about what is known (e.g., putative mechanisms, identification, and avoidance of triggers) and given instructions on fluid and salt management 64,65 . A supervised POTS‐dedicated exercise program starting with recumbent exercise and gradual increase in intensity, resistance, and duration followed by shifting to an upright position is recommended.…”

Section: Management Of Pascmentioning

confidence: 99%

Cardiovascular dysautonomia in postacute sequelae of SARS‐CoV‐2 infection

Ståhlberg,

Mahdi,

Johansson

et al. 2023

Cardiovasc electrophysiol

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Coronavirus disease 2019 (COVID‐19) has led to a worldwide pandemic that continues to transform but will not go away. Cardiovascular dysautonomia in postacute sequelae of severe acute respiratory syndrome coronavirus 2 infection has led to persistent symptoms in a large number of patients. Here, we define the condition and its associated symptoms as well as potential mechanisms responsible. We provide a careful and complete overview of the topic addressing novel studies and a generalized approach to the management of individuals with this complex and potentially debilitating problem. We also discuss future research directions and the important knowledge gaps to be addressed in ongoing and planned studies.

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Section: Management Of Pascmentioning

confidence: 99%

Cardiovascular dysautonomia in postacute sequelae of SARS‐CoV‐2 infection

Ståhlberg,

Mahdi,

Johansson

et al. 2023

Cardiovasc electrophysiol

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“…In patients with post-COVID-19 dysautonomia, such as postural orthostatic tachycardia syndrome, breathing exercises in an upright position can be challenging and a supine position during exercise should instead be recommended. 87 – 89 …”

Section: Standardmentioning

confidence: 99%

Clinical standards for diagnosis, treatment and prevention of post-COVID-19 lung disease

Visca,

Centis,

Pontali

et al. 2023

int j tuberc lung dis

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BACKGROUND: The aim of these clinical standards is to provide guidance on ‘best practice’ care for the diagnosis, treatment and prevention of post-COVID-19 lung disease.METHODS: A panel of international experts representing scientific societies, associations and groups active in post-COVID-19 lung disease was identified; 45 completed a Delphi process. A 5-point Likert scale indicated level of agreement with the draft standards. The final version was approved by consensus (with 100% agreement).RESULTS: Four clinical standards were agreed for patients with a previous history of COVID-19: Standard 1, Patients with sequelae not explained by an alternative diagnosis should be evaluated for possible post-COVID-19 lung disease; Standard 2, Patients with lung function impairment, reduced exercise tolerance, reduced quality of life (QoL) or other relevant signs or ongoing symptoms ≥4 weeks after the onset of first symptoms should be evaluated for treatment and pulmonary rehabilitation (PR); Standard 3, The PR programme should be based on feasibility, effectiveness and cost-effectiveness criteria, organised according to local health services and tailored to an individual patient’s needs; and Standard 4, Each patient undergoing and completing PR should be evaluated to determine its effectiveness and have access to a counselling/health education session.CONCLUSION: This is the first consensus-based set of clinical standards for the diagnosis, treatment and prevention of post-COVID-19 lung disease. Our aim is to improve patient care and QoL by guiding clinicians, programme managers and public health officers in planning and implementing a PR programme to manage post-COVID-19 lung disease.

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“…Post-COVID-19 conditions of varying severity can occur after COVID-19 and present a range of persistent symptoms, with fatigue, dyspnea and cognitive problems being the most common [1,3]. These enduring symptoms can hamper daily activities, limit physical activity, lead to psychological symptoms and cognitive dysfunction, and subsequently impact quality of life [5][6][7][8]. Currently, there is no standardized clinical assessment for measuring the impact of post-COVID-19 on an individual's everyday life [9].…”

Section: Introductionmentioning

confidence: 99%

“…Levels that were significant: MO level 4*; ADL level 3**; AC levels 3**, 4**, 5** 7. Levels that were significant: MO level 4*; ADL level 3**; AC levels 3**, 4**, 5** 8. Levels that were significant: MO level 4*; ADL level 3**; AC levels 3**, 4**, 5**.…”

mentioning

confidence: 96%

Enhancing EQ-5D-5L Sensitivity in Capturing the Most Common Symptoms in Post-COVID-19 Patients: An Exploratory Cross-Sectional Study with a Focus on Fatigue, Memory/Concentration Problems and Dyspnea Dimensions

Janols,

Wadsten,

Forssell

et al. 2024

IJERPH

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This study aimed to determine whether the EQ-5D-5L tool captures the most common persistent symptoms, such as fatigue, memory/concentration problems and dyspnea, in patients with post-COVID-19 conditions while also investigating if adding these symptoms improves the explained variance of the health-related quality of life (HRQoL). In this exploratory cross-sectional study, two cohorts of Swedish patients (n = 177) with a history of COVID-19 infection answered a questionnaire covering sociodemographic characteristics and clinical factors, and their HRQoL was assessed using EQ-5D-5L with the Visual Analogue Scale (EQ-VAS). Spearman rank correlation and multiple regression analyses were employed to investigate the extent to which the most common persistent symptoms, such as fatigue, memory/concentration problems and dyspnea, were explained by the EQ-5D-5L. The explanatory power of EQ-5D-5L for EQ-VAS was also analyzed, both with and without including symptom(s). We found that the EQ-5D-5L dimensions partly captured fatigue and memory/concentration problems but performed poorly in regard to capturing dyspnea. Specifically, the EQ-5D-5L explained 55% of the variance in memory/concentration problems, 47% in regard to fatigue and only 14% in regard to dyspnea. Adding fatigue to the EQ-5D-5L increased the explained variance of the EQ-VAS by 5.7%, while adding memory/concentration problems and dyspnea had a comparatively smaller impact on the explained variance. Our study highlights the EQ-5D-5L’s strength in capturing fatigue and memory/concentration problems in post-COVID-19 patients. However, it also underscores the challenges in assessing dyspnea in this group. Fatigue emerged as a notably influential symptom, significantly enhancing the EQ-5D-5L’s predictive ability for these patients’ EQ-VAS scores.

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Cardiorespiratory dysautonomia in post‐COVID‐19 condition: Manifestations, mechanisms and management

Cited by 14 publications

References 101 publications

Cardiovascular dysautonomia in postacute sequelae of SARS‐CoV‐2 infection

Cardiovascular dysautonomia in postacute sequelae of SARS‐CoV‐2 infection

Clinical standards for diagnosis, treatment and prevention of post-COVID-19 lung disease

Enhancing EQ-5D-5L Sensitivity in Capturing the Most Common Symptoms in Post-COVID-19 Patients: An Exploratory Cross-Sectional Study with a Focus on Fatigue, Memory/Concentration Problems and Dyspnea Dimensions

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