Autonomic dysfunction post–acute COVID-19 infection
Open accessAbstract
SARS-CoV-2 infection, which causes the disease COVID-19, is most known for its severe respiratory complications. However, a variety of extrapulmonary effects have since been described, with cardiovascular complications being among the most common.1 Those who recover from the acute phase of COVID-19 may be left with residual symptoms such as chest pain and dyspnea, resulting in a decreased quality of life and a syndrome sometimes described as “long COVID.”2 Recent evidence suggests that survivors with some of these chronic symptoms may have autonomic dysfunction (AD) with features of postural orthostatic tachycardia syndrome (POTS) and/or inappropriate sinus tachycardia (IST).
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Many patients with POTS describe a postviral onset.
“Many patients describe a postviral onset,29–32”
From Diagnosis and management of postural orthostatic tachycardia syndrome (2022) · cites this paper as [32]
The Introduction describes POTS-like autonomic symptoms after COVID-19, and the Case report identifies two patients diagnosed with POTS in a small post-COVID cohort. This supports a postviral onset in some cases, but the paper does not establish that many POTS patients generally describe such an onset. (LLM, conf=0.84)
Experimental — accuracy not yet measuredPOTS may have an immunological cause.
“Postural orthostatic tachycardia syndrome may have an immunological cause.”
From Diagnosis and management of postural orthostatic tachycardia syndrome (2022) · cites this paper as [32]
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Cites
Sheldon, R. S., Grubb, B. P., Olshansky, B., Shen, W.-K., Calkins, H., Brignole, M., Raj, S. R., Krahn, A. D., Morillo, C. A., Stewart, J. M., et al. (2015) · Heart Rhythm · doi:10.1016/j.hrthm.2015.03.029 · Cited by 1,013 · see citing works
Inappropriate sinus tachycardia
Olshansky, B., & Sullivan, R. M. (2013) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2012.07.074 · Cited by 182 · see citing works
Flagged first, then by citations
Research works printed but not linked: 13
- [1]Gupta A. Madhavan M.V. Sehgal K. Extrapulmonary manifestations of COVID-19 Nat Med 26 2020 1017 1032 32651579 PMC11972613
- [2]Nalbandian A. Sehgal K. Gupta A. Post-acute COVID-19 syndrome Nat Med 27 2021 601 615 33753937 PMC8893149
- [3]Shouman K. Vanichkachorn G. Cheshire W.P. Autonomic dysfunction following COVID-19 infection: an early experience Clin Auton Res 31 2021 385 394 33860871 PMC8050227
- [4]Johansson M. Stahlberg M. Runold M. Long-haul post-COVID-19 symptoms presenting as a variant of postural orthostatic tachycardia syndrome: the Swedish experience JACC Case Rep 3 2021 573 580 33723532 PMC7946344
- [5]Agarwal A.K. Garg R. Ritch A. Sarkar P. Postural orthostatic tachycardia syndrome Postgrad Med J 83 2007 478 480 17621618 PMC2600095
- [7]Wells R. Tonkin A. Clinical approach to autonomic dysfunction Intern Med J 46 2016 1134 1139 27734621
- [9]Desai A.D. Boursiquot B.C. Melki L. Wan E.Y. Management of arrhythmias associated with COVID-19 Curr Cardiol Rep 23 2020 2 33231782 PMC7685181
- [10]Blitshteyn S. Whitelaw S. Postural orthostatic tachycardia syndrome (POTS) and other autonomic disorders after COVID-19 infection: a case series of 20 patients Immunol Res 69 2021 205 211 33786700 PMC8009458
- [11]Shabtaie S.A. Witt C.M. Asirvatham S.J. Natural history and clinical outcomes of inappropriate sinus tachycardia J Cardiovasc Electrophysiol 31 2020 137 143 31749258
- [12]Arnold A.C. Ng J. Raj S.R. Postural tachycardia syndrome - diagnosis, physiology, and prognosis Auton Neurosci 215 2018 3 11 29523389 PMC6113123
- [13]Raw R.K. Kelly C.A. Rees J. Wroe C. Chadwick D.R. Previous COVID-19 infection, but not Long-COVID, is associated with increased adverse events following BNT162b2/Pfizer vaccination J Infect 83 2021 381 412 PMC8164507 34062184
- [14]Antonelli M. Penfold R.S. Merino J. Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the COVID Symptom Study app: a prospective, community-based, nested, case-control study (published online ahead of print) Lancet Infect Dis 2021 09.01. 10.1016/S1473-3099(21)00460-6 PMC8409907 34480857 · DOI · Paper page
- [15]Goldstein D.S. The possible association between COVID-19 and postural tachycardia syndrome Heart Rhythm 18 2021 508 509 33316414 PMC7729277
Cited by
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Diagnosis and management of postural orthostatic tachycardia syndrome
Raj, S. R., Fedorowski, A., & Sheldon, R. S. (2022) · Canadian Medical Association Journal · doi:10.1503/cmaj.211373 · Cited by 95 · see citing works
- Authors
- Desai, A. D., Boursiquot, B. C., Moore, C. J., Gopinathannair, R., Waase, M. P., Rubin, G. A., & Wan, E. Y.
- Affiliations
- Rutgers New Jersey Medical School (US)
- Columbia University (US)
- Kansas City Heart Rhythm Institute (US)
- Corresponding author
- Wan, Elaine Y.
- Venue
- HeartRhythm Case Reports
- Publisher
- Elsevier BV
- Published
- 2022-03
- Volume
- 8
- Issue
- 3
- Pages
- 143-146
- ISSN
- 2214-0271 (ISSN-L)
- PMC
- PMC8626157
- OpenAlex
- W3217552502
- Cited by
- 23
- References
- 2
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 4 · 2023: 6 · 2022: 8 · 2021: 1
- FWCI
- 2.27
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- HeartRhythm Case Reports (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL152236)
- Topics
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- autonomic dysfunction, long COVID, SARS-CoV-2, postural orthostatic tachycardia syndrome, inappropriate sinus tachycardia, cardiovascular complications, residual symptoms
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