High Incidence of Autonomic Dysfunction and Postural Orthostatic Tachycardia Syndrome in Patients with Long COVID: Implications for Management and Health Care Planning - 28/07/23
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Abstract |
Background |
Autonomic dysfunction, including postural orthostatic tachycardia syndrome (POTS), has been reported in individuals with post-acute sequelae of COVID-19 (PASC). However, the degree of dysautonomia in PASC has not been compared to those with POTS and healthy controls.
Methods |
All participants were prospectively enrolled between August 5, 2021 and October 31, 2022. Autonomic testing included beat-to-beat hemodynamic monitoring to assess respiratory sinus arrhythmia, Valsalva ratio, and orthostatic changes during a 10-minute active standing test, as well as sudomotor assessment. The Composite Autonomic Symptom Score (COMPASS-31) was used to assess symptoms and the EuroQuol 5-Dimension survey (EQ-5D-5L) was used to assess health-related quality of life (HrQoL) measures.
Results |
A total of 99 participants (n = 33 PASC, n = 33 POTS, and n = 33 healthy controls; median age 32 years, 85.9% females) were included. Compared with healthy controls, the PASC and POTS cohorts demonstrated significantly reduced respiratory sinus arrhythmia (P < .001), greater heart rate increase during 10-minute active standing test (P < .001), greater burden of autonomic dysfunction evidenced by higher COMPASS-31 scores across all subdomains (all P < .001), and poor HrQoL across all EQ-5D-5L domains (all P < .001), lower median EuroQol-visual analogue scale (P < .001), and lower utility scores (P < .001). The majority (79%) of those with PASC met the internationally established criteria for POTS.
Conclusion |
The prevalence of autonomic symptomology for POTS was high in those with PASC, leading to poor HrQoL and high health disutility. Autonomic testing should be routinely undertaken in those with PASC to aid diagnosis and direct appropriate management to improve health outcomes.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
High incidence of autonomic dysfunction with high symtom burden and significant impairment in health-related quality of life in those with PASC
High incidence of autonomic dysfunction with high symtom burden and significant impairment in health-related quality of life in those with PASCImage, graphical abstractLe texte complet de cet article est disponible en PDF.
Keywords : Autonomic function, Dysautonomia, Long COVID, Orthostatic intolerance, Post-acute sequelae of COVID-19, Postural orthostatic tachycardia syndrome
Plan
| Funding: This work was supported by a research grant from Standing up to POTS (North Hampton, Ohio, USA) and an equipment grant from The Australian POTS Foundation (Adelaide, SA, Australia). |
|
| Conflicts of Interest: M-CS is supported by an Australian Government Research scholarship; DHL reports that the University of Adelaide has received on his behalf lecture and/or consulting fees from Abbott Medical, Biotronik, Medtronic, and MicroPort CRM. All other authors have no conflicts of interest to declare. |
|
| Authorship: All authors contributed significantly to this work and had access to the data, with role in writing the manuscript. |
|
| Trial registration: ANZCTR 12621000476831 |
Bienvenue sur EM-consulte, la référence des professionnels de santé.