medigraphic.com
Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán

2023, Number 3

<< Back Next >>

Rev Biomed 2023; 34 (3)

Postural Orthostatic Tachycardia and autonomic disorders in post COVID-19 Syndrome

Hernández-Perera A, Chuisent-Gómez IT, Suarez-Renol D, Nodarse-AEC

Language: Spanish
References: 23
Page: 280-286
PDF size: 120.93 Kb.


ABSTRACT

Introduction. COVID-19 caused a health emergency worldwide given its rapid transmissibility and spread. The high frequency of diverse clinical manifestations, once the acute phase concluded, was shocking. The later is termed post COVID-19 syndrome. Autonomic dysfunction could be one of the causes of persistent symptoms and be related to it.
Objective. To evaluate the presence of Postural Orthostatic Tachycardia and autonomic disorders in a group of patients with post COVID-19 syndrome.
Material and method. An evaluation of 18 patients aged 25 to 70 years with symptoms of poor tolerance to exertion and tachycardia at rest or change of position was carried out. All included patients underwent C-reactive protein, Ferritin and LDH, as well as like the NASA 10-Minute Lean Test.
Results. Of 18 patients evaluated, 12 patients were diagnosed with autonomic disorders with a median age of 45 years, 7 patients were defined as Postural Orthostatic Tachycardia, 3 as Inappropriate Sinus Tachycardia, 1 as Neurocardiogenic Syncope and 1 as Orthostatic Hypotension.
Conclusions. It is evident that autonomic disorders may be present in post COVID-19 syndrome in patients who experience persistent neurological and cardiovascular symptoms. Clinicians should be aware that these autonomic disorders may be a complication of COVID-19.


REFERENCES

  1. Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S,Sehrawat TS, et al. Extrapulmonary manifestations ofCOVID-19. Nat Med. 2020 Jul;26(7):1017-1032. http://dx.doi.org/10.1038/s41591-020-0968-3

  2. Nalbandian A, Sehgal K, Gupta A, Madhavan MV,McGroder C, Stevens JS, et al. Post-acute COVID-19syndrome. Nat Med. 2021 Apr;27(4):601-615. http://dx.doi.org/10.1038/s41591-021-01283-z.

  3. Dani M, Dirksen A, Taraborrelli P, Torocastro M,Panagopoulos D, Sutton R, et al. Autonomic dysfunctionin ‘long COVID’: rationale, physiology and managementstrategies. Clin Med (Lond). 2021 Jan;21(1):e63-e67.http://dx.doi.org/10.7861/clinmed.2020-0896.

  4. National Institute for Health and Care ExcellenceCOVID-19 rapid guideline: managing the long-termeffects of COVID-19. https://www.nice.org.uk/guidance/ng188

  5. Gluckman TJ, Bhave NM, Allen LA, Chung EH, Spatz ES,Ammirati E, et al. 2022 ACC Expert Consensus DecisionPathway on Cardiovascular Sequelae of COVID-19 inAdults: Myocarditis and Other Myocardial Involvement,Post-Acute Sequelae of SARS-CoV-2 Infection, andReturn to Play: A Report of the American College ofCardiology Solution Set Oversight Committee. J AmColl Cardiol. 2022 May 3;79(17):1717-1756. http://dx.doi.org/10.1016/j.jacc.2022.02.003.

  6. Sheldon RS, Grubb BP 2nd, Olshansky B, ShenWK, Calkins H, Brignole M, et al. 2015 heart rhythmsociety expert consensus statement on the diagnosisand treatment of postural tachycardia syndrome,inappropriate sinus tachycardia, and vasovagal syncope.Heart Rhythm. 2015 Jun;12(6):e41-63. http://dx.doi.org/10.1016/j.hrthm.2015.03.029.

  7. Goldstein DS. The possible association betweenCOVID-19 and postural tachycardia syndrome. HeartRhythm. 2021 Apr;18(4):508-509. http://dx.doi.org/10.1016/j.hrthm.2020.12.007.

  8. Shouman K, Vanichkachorn G, Cheshire WP, SuarezMD, Shelly S, Lamotte GJ, et al. Autonomic dysfunctionfollowing COVID-19 infection: an early experience.Clin Auton Res. 2021 Jun;31(3):385-394. http://dx.doi.org/10.1007/s10286-021-00803-8.

  9. Johansson M, Stĺhlberg M, Runold M, Nygren-BonnierM, Nilsson J, Olshansky B, et al. Long-Haul Post-COVID-19 Symptoms Presenting as a Variant of PosturalOrthostatic Tachycardia Syndrome: The SwedishExperience. JACC Case Rep. 2021 Apr;3(4):573-580.http://dx.doi.org/10.1016/j.jaccas.2021.01.009.

  10. Williams DP, Koenig J, Carnevali L, Sgoifo A, JarczokMN, Sternberg EM, et al. Heart rate variability andinflammation: A meta-analysis of human studies.Brain Behav Immun. (2019) 80:219–26. http://dx.doi.org/10.1016/j.bbi.2019.03.009

  11. Vernon SD, Funk S, Bateman L, Stoddard GJ,Hammer S, Sullivan K, et al. Orthostatic ChallengeCauses Distinctive Symptomatic, Hemodynamic andCognitive Responses in Long COVID and MyalgicEncephalomyelitis/Chronic Fatigue Syndrome. FrontMed (Lausanne). 2022 Jun 23;9:917019. http://dx.doi.org/10.3389/fmed.2022.917019.

  12. Lee J, Vernon SD, Jeys P, Ali W, Campos A, UnutmazD, et al. Hemodynamics during the 10-minute NASALean Test: evidence of circulatory decompensation ina subset of ME/CFS patients. J Transl Med. 2020 Aug15;18(1):314. http://dx.doi.org/10.1186/s12967-020-02481-y

  13. Bryarly M, Phillips LT, Fu Q, Vernino S, Levine BD.Postural Orthostatic Tachycardia Syndrome: JACC FocusSeminar. J Am Coll Cardiol. 2019 Mar 19; 73(10):1207-1228. http://dx.doi.org/10.1016/j.jacc.2018.11.059

  14. Blitshteyn, S., Whitelaw, S. Postural orthostatictachycardia syndrome (POTS) and other autonomicdisorders after COVID-19 infection: a case series of 20patients. Immunol Res 69, 205–211 (2021). http://dx.doi.org/10.1007/s12026-021-09185-5

  15. Li H, Yu X, Liles C, Khan M, Vanderlinde-Wood M, Galloway A, et al. Autoimmune basisfor postural tachycardia syndrome. J Am HeartAssoc. 2014;3:e000755. http://dx.doi.org/10.1161/JAHA.113.000755

  16. Fedorowski A, Li H, Yu X, Koelsch KA, Harris VM,Liles C. et al. Antiadrenergic autoimmunity in posturaltachycardia syndrome. Europace. 2017;19(7):1211–1219 http://dx.doi.org/10.1093/europace/euw154

  17. Blitshteyn S. Autoimmune markers and autoimmunedisorders in patients with postural tachycardia syndrome(POTS). Lupus. 2015;24(13):1364–9. http://dx.doi.org/10.1177/0961203315587566

  18. Barizien N, Le Guen M, Russel S, Touche P, Huang F,Vallee A. Clinical characterization of dysautonomiain long COVID-19 patients. Sci Rep. 2021; 11:14042.http://dx.doi.org/10.1038/s41598-021-93546-5

  19. Watari M, Nakane S, Mukaino A, Nakajima M, MoriY, Maeda Y, et al. Autoimmune postural orthostatictachycardia syndrome. Ann Clin Transl Neurol, 2018; 5:486-492. https://doi.org/10.1002/acn3.524

  20. Ormiston CK, Świątkiewicz I, Taub PR. Posturalorthostatic tachycardia syndrome as a sequela ofCOVID-19. Heart Rhythm. 2022 Jul 16;19(11):1880–9.https://doi.org/10.1016/j.hrthm.2022.07.014

  21. Moreno JD, Schmidt U, Joffe S. The Nuremberg Code 70Years Later. JAMA. 2017 Sep 5;318(9):795-796. http://dx.doi.org/10.1001/jama.2017.10265. PMID: 28817743.

  22. Malik AY, Foster C. The revised Declaration of Helsinki:cosmetic or real change? Journal of the Royal Societyof Medicine. 2016;109(5):184-189. http://dx.doi.org/10.1177/0141076816643332

  23. Povl Riis (2003) Thirty Years of Bioethics: The HelsinkiDeclaration 1964-2003, New Review of Bioethics, 1:1,15-25. http://dx.doi.org/10.1080/1740028032000131396




2020     |     www.medigraphic.com