RT Journal Article
SR Electronic
T1 Autonomic dysfunction in ‘long COVID’: rationale, physiology and management strategies
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP e63
OP e67
DO 10.7861/clinmed.2020-0896
VO 21
IS 1
A1 Melanie Dani
A1 Andreas Dirksen
A1 Patricia Taraborrelli
A1 Miriam Torocastro
A1 Dimitrios Panagopoulos
A1 Richard Sutton
A1 Phang Boon Lim
YR 2021
UL http://www.rcpjournals.org/content/21/1/e63.abstract
AB The SARS-CoV-2 (COVID-19) pandemic has caused unprecedented morbidity, mortality and global disruption. Following the initial surge of infections, focus shifted to managing the longer-term sequelae of illness in survivors. ‘Post-acute COVID’ (known colloquially as ‘long COVID’) is emerging as a prevalent syndrome. It encompasses a plethora of debilitating symptoms (including breathlessness, chest pain, palpitations and orthostatic intolerance) which can last for weeks or more following mild illness. We describe a series of individuals with symptoms of ‘long COVID’, and we posit that this condition may be related to a virus- or immune-mediated disruption of the autonomic nervous system resulting in orthostatic intolerance syndromes. We suggest that all physicians should be equipped to recognise such cases, appreciate the symptom burden and provide supportive management. We present our rationale for an underlying impaired autonomic physiology post-COVID-19 and suggest means of management.