August 12, 2021Journal of Neurology150 citationsOpen Access

Autonomic dysfunction in post-COVID patients with and witfhout neurological symptoms: a prospective multidomain observational study

ASAlex Buoite StellaUniversity of Trieste GFGiovanni FurlanisUniversity of Trieste NFNicolò Arjuna FrezzaUniversity of Trieste

Structured PICO

Does the severity and domain of autonomic dysfunction differ between post-COVID patients with and without neurological symptoms?

Population

180 post-COVID patients evaluated between 4 weeks and 9 months from COVID-19 symptoms onset, mean age 51 ± 13 years, 70.6% female.

Intervention

Presence of neurological symptoms post-COVID

Comparator

Absence of neurological symptoms post-COVID

Outcome

Autonomic dysfunction assessed by COMPASS-31 questionnaire score and prevalence of orthostatic hypotension via active stand testpatient reported

Autonomic dysfunction, including orthostatic hypotension and symptoms measured by COMPASS-31, is prevalent in post-COVID patients and is more severe in those with neurological symptoms.

Abstract

The autonomic nervous system (ANS) can be affected by COVID-19, and dysautonomia may be a possible complication in post-COVID individuals. Orthostatic hypotension (OH) and postural tachycardia syndrome (POTS) have been suggested to be common after SARS-CoV-2 infection, but other components of ANS function may be also impaired. The Composite Autonomic Symptom Scale 31 (COMPASS-31) questionnaire is a simple and validated tool to assess dysautonomic symptoms. The aim of the present study was to administer the COMPASS-31 questionnaire to a sample of post-COVID patients with and without neurological complaints. Participants were recruited among the post-COVID ambulatory services for follow-up evaluation between 4 weeks and 9 months from COVID-19 symptoms onset. Participants were asked to complete the COMPASS-31 questionnaire referring to the period after COVID-19 disease. Heart rate and blood pressure were manually taken during an active stand test for OH and POTS diagnosis. One-hundred and eighty participants were included in the analysis (70.6% females, 51 ± 13 years), and OH was found in 13.8% of the subjects. Median COMPASS-31 score was 17.6 (6.9-31.4), with the most affected domains being orthostatic intolerance, sudomotor, gastrointestinal and pupillomotor dysfunction. A higher COMPASS-31 score was found in those with neurological symptoms (p < 0.01), due to more severe orthostatic intolerance symptoms (p < 0.01), although gastrointestinal (p < 0.01), urinary (p < 0.01), and pupillomotor (p < 0.01) domains were more represented in the non-neurological symptoms group. This study confirms the importance of monitoring ANS symptoms as a possible complication of COVID-19 disease that may persist in the post-acute period.

KI fragen

Bookmark

View Full Paper