SARS-CoV-2 infection associated with micturition syncope

Abstract

Rationale: Syncope is described as the loss of consciousness and postural muscle tone with a short duration and fast onset. Micturition syncope can be caused by abnormal vasovagal response or by the dysfunction of the blood pressure regulating mechanism, which occurs before, during, or immediately after urination. Patient concerns: We present 4 cases of COVID-19 hospitalized in the Department of Infectious Diseases of the Academic Emergency Hospital Sibiu, Romania, cases that presented micturition syncope. Diagnoses: During hospitalization, patients confirmed with SARS-Cov-2 infection using real time reverse transcriptase-polymerase chain reaction (RT-PCR) assay, presented micturition syncope in different stages of the infection (at the beginning and in the second week of evolution). Interventions: Other causes of syncope such as adrenal insufficiency secondary to corticosteroids treatment, cardiac rhythm disorders, neurological impairment, dehydration, vasoactive medication, malignancies, pulmonary hypertension and coughing were excluded. The treatment of SARS-CoV-2 infection was performed following the local and national guidelines. Outcomes: The clinical course of all 4 patients diagnosed with COVID-19 and micturition syncope was favorable. To our knowledge, micturition syncope in COVID-19 patients has yet not been reported by other authors. Lessons: To our knowledge, micturition syncope associated with the evolution of COVID-19, has yet not been reported by other authors.

Syncope and COVID-19 disease – A systematic review

“…10 case reports alluded to possible cardiac etiology for syncope (Sang et al, 2020, Pasquetto et al, 2020, Luetkens et al, 2020, Chang et al, 2020, Khan et al, 2020, Chalela et al, 2020, Chibane et al, 2020, Pendower et al, 2020, Aoi et al, 2020, Doodnauth et al, 2021 as well as 1 case series (Espinoza et al, 2021), while another 6 studies attributed the cause of syncope to orthostatic hypotension (Ebrille et al, 2020, Tapé et al, 2013, Logmin et al, 2020, Singhania et al, 2020, Huang et al, 2020, Omotosho et al, 2021. In turn, reflex syncope was highlighted in only 3 of the studies (Ebrille et al, 2020, Canetta et al, 2020, Birlutiu et al, 2020. The retrospective study by Oates et al (2020) contemplated all of the different types of syncope.…”

“…Of the 37 included articles, 18 were case reports (Tapé et al, 2013, Sang et al, 2020, Pasquetto et al, 2020, Luetkens et al, 2020, Logmin et al, 2020, Chang et al, 2020, Singhania et al, 2020, Huang et al, 2020, Omotosho et al, 2021, Khan et al, 2020, Chalela et al, 2020, Pérez et al, 2020, Chibane et al, 2020, Pendower et al, 2020, Aoi et al, 2020, Doodnauth et al, 2021, Kanjwal et al, 2020, Miglis et al, 2020, 10 were retrospective analyses (Oates et al, 2020, Romero-Sánchez et al, 2020, Chachkhiani et al, 2020, Xiong et al, 2020, Radmanesh et al, 2020, Canetta et al, 2020, Chuang et al, 2021, Mizrahi et al, 2020, Martín-Sánchez et al, 2020, Travi et al, 2020, 5 were case-series (Ebrille et al, 2020, Birlutiu et al, 2020, Argenziano et al, 2020, Espinoza et al, 2021, Gonfiotti et al, 2020 and 2 were prospective studies (García-Moncó et al, 2020, Chen et al, 2020. One was a letter (Lam et al, 2020).…”

“…Regarding the comorbidities of patients with COVID-19 and syncope, arterial hypertension was heavily represented in 21 studies (Oates et al, 2020, Ebrille et al, 2020, Romero-Sánchez et al, 2020, Tapé et al, 2013, Sang et al, 2020, Singhania et al, 2020, Pérez et al, 2020, Aoi et al, 2020, Doodnauth et al, 2021, Chachkhiani et al, 2020, Canetta et al, 2020, Chuang et al, 2021, Mizrahi et al, 2020, Martín-Sánchez et al, 2020, Travi et al, 2020, Birlutiu et al, 2020, Argenziano et al, 2020, Espinoza et al, 2021, Gonfiotti et al, 2020, García-Moncó et al, 2020, Lam et al, 2020, making it the most prevalent comorbid condition exhibited by the participants. This was followed by Diabetes mellitus, obesity, dyslipidemia and heart disease.…”

Syncope and COVID-19 disease – a systematic review

“…Of the 19 included articles, 8 were case reports (8) (9) (10) (11) (12) (13) (14) (15), 6 were retrospective analyses (3) (7) (16) (17) (18) (19), 3 were case-series (6) (20) (21) and 2 were prospective studies (22) (23). Given the nature of the topic at hand, every article was published in 2020.…”

“…Orthostatic hypotension accounted for 3.6% (9/248) and presumable cardiac syncope was responsible for 2.0% (5/248). Regarding comorbidities, hypertension was heavily represented in 11 studies (3) (6) (7) (8) (9) (14) (16) (19) (20) (21) (22), making it the most prevalent comorbid condition exhibited by the participants. This was closely followed by Diabetes mellitus, obesity, dyslipidemia and heart disease.…”