Background: Autonomic dysfunction is a known complication of post-acute sequelae of SARS-CoV-2 (PASC)/long COVID, however prevalence and severity are unknown.
Objective: To assess the frequency, severity, and risk factors of autonomic dysfunction in PASC, and to determine whether severity of acute SARS-CoV-2 infection is associated with severity of autonomic dysfunction.
Design: Cross-sectional online survey of adults with PASC recruited through long COVID support groups between October 2020 and August 2021.
Participants: 2,413 adults ages 18-64 years with PASC including patients who had a confirmed positive test for COVID-19 (test-confirmed) and participants who were diagnosed with COVID-19 based on clinical symptoms alone.
Main Measures: The main outcome measure was the Composite Autonomic Symptom 31 (COMPASS-31) total score, used to assess global autonomic dysfunction. Test-confirmed hospitalized vs. test-confirmed non-hospitalized participants were compared to determine if the severity of acute SARS-CoV-2 infection was associated with the severity autonomic dysfunction.
Key Results: Sixty-six percent of PASC patients had a COMPASS-31 score >20, suggestive of moderate to severe autonomic dysfunction. COMPASS-31 scores did not differ between test-confirmed hospitalized and test-confirmed non-hospitalized participants [28.95 (15.62, 46.60) vs. 26.4 (13.75, 42.10); = 0.06].
Conclusions: Evidence of moderate to severe autonomic dysfunction was seen in 66% of PASC patients in our study, independent of hospitalization status, suggesting that autonomic dysfunction is highly prevalent in the PASC population and independent of the severity of acute COVID-19 illness.
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http://dx.doi.org/10.3389/fneur.2022.1012668 | DOI Listing |
Hypertension
December 2024
Vanderbilt Autonomic Dysfunction Center, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN. (L.E.O., A.D., C.A.S., A.G., B.K.B., S.P., I.B.).
Background: The cholinesterase inhibitor pyridostigmine is used to treat orthostatic hypotension by facilitating cholinergic neurotransmission in autonomic ganglia, thereby harnessing residual sympathetic tone to increase blood pressure (BP) preferentially in the upright posture. We hypothesized that less severe autonomic impairment was associated with greater pressor responses to pyridostigmine.
Methods: To identify predictors of pressor response, linear regression analyses between the effect of pyridostigmine on upright BP and markers of autonomic impairment were retrospectively conducted on 38 patients who had a medication trial with pyridostigmine (60 mg single dose).
J Physiol
December 2024
Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE, USA.
Transl Neurodegener
December 2024
Department of Anatomy and Medical Imaging, University of Auckland, 85 Park Road, Grafton, , Auckland, 1142, New Zealand.
Background: Parkinson's disease (PD) and multiple system atrophy (MSA) are classified as α-synucleinopathies and are primarily differentiated by their clinical phenotypes. Delineating these diseases based on their specific α-synuclein (α-Syn) proteoform pathologies is crucial for accurate antemortem biomarker diagnosis. Newly identified α-Syn pathologies in PD raise questions about whether MSA exhibits a similar diversity.
View Article and Find Full Text PDFNeuropsychiatr Dis Treat
December 2024
Department of Neurology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People's Republic of China.
Parkinson's disease (PD) is primarily recognized for its motor symptoms, yet non-motor symptoms (NMS) such as neuropsychiatric disturbances, sleep disorders, autonomic dysfunction, and sensory abnormalities significantly contribute to the disease's overall burden. While traditional pharmacological and surgical treatments have primarily targeted motor symptoms, alternative therapies such as acupuncture, cognitive therapy, and Traditional Chinese Medicine (TCM) are gaining attention for managing NMS. This review provides a comprehensive analysis of alternative therapies for NMS in PD, drawing on evidence from international guidelines and TCM.
View Article and Find Full Text PDFFront Sports Act Living
December 2024
Department of Health, LUNEX University of Applied Sciences, Differdange, Luxembourg.
Objectives: To conduct a systematic review to determine the acute and chronic effects of inspiratory muscle training (IMT) in type 2 diabetes mellitus (T2DM) patients on cardiac autonomic function, glucose variability, inspiratory muscle strength and endurance, hemodynamic variables, and exercise capacity.
Methods: A search was carried out according to a specific search strategy, following the PRISMA statement, and three independent reviewers have undertaken the article selection process. Searches were carried out in June 2023, on the following electronic databases: EMBASE, MEDLINE (PubMed), SCOPUS (Elsevier), and Web of Science.
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