Impaired parasympathetic function in long-COVID postural orthostatic tachycardia syndrome – a case-control study

Bioelectronic Medicine

Short Report

Cyndya A. Shibao¹  Luis E. Okamoto¹  Vasile Urechie¹  Italo Biaggioni¹  Andrè Diedrich²  Stefano Rigo³ 

[1] Department of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA;Department of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA;Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA;Department of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA;Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy;

关键词: Long-COVID;    POTS;    ANS;    Parasympathetic;    HRV;    Spectra;   

DOI  :  10.1186/s42234-023-00121-6

 received in 2023-06-18, accepted in 2023-08-12,  发布年份 2023

来源: Springer

【 摘 要 】

PurposeEighty percent of patients infected by SARS-CoV-2 report persistence of one symptom beyond the 4-week convalescent period. Those with orthostatic tachycardia and orthostatic symptoms mimicking postural tachycardia syndrome, they are defined as Long-COVID POTS [LCP]. This case-control study investigated potential differences in autonomic cardiovascular regulation between LCP patients and healthy controls.MethodsThirteen LCP and 16 healthy controls, all female subjects, were studied without medications. Continuous blood pressure and ECG were recorded during orthostatic stress test, respiratory sinus arrhythmia, and Valsalva maneuver. Time domain and power spectral analysis of heart rate [HR] and systolic blood pressure [SBP] variability were computed characterizing cardiac autonomic control and sympathetic peripheral vasoconstriction.ResultsLCP had higher deltaHR (+ 40 ± 6 vs. + 21 ± 3 bpm, p = 0.004) and deltaSBP (+ 8 ± 4 vs. -1 ± 2 mmHg, p = 0.04) upon standing; 47% had impaired Valsalva maneuver ratio compared with 6.2% in controls (p = 0.01). Spectral analysis revealed that LCP had lower RMSSD (32.1 ± 4.6 vs. 48.9 ± 6.8 ms, p = 0.04) and HFRRI, both in absolute (349 ± 105 vs. 851 ± 253ms2, p = 0.03) and normalized units (32 ± 4 vs. 46 ± 4 n.u., p = 0.02). LFSBP was similar between groups.ConclusionsLCP have reduced cardiovagal modulation, but normal sympathetic cardiac and vasoconstrictive functions. Impaired parasympathetic function may contribute to the pathogenesis of Long-COVID POTS syndrome.

【 授权许可】

CC BY   
© Feinstein Institute for Medical Research 2023

【 图 表 】

Fig. 9