Table 1.

Symptom profile of individuals attending our clinic with autonomic symptoms following viral infection during the COVID-19 pandemic

PatientSymptomsTiming of antecedent illnessObservations in clinicOther investigationsClinical diagnosis
26-year-old femalePalpitations on standing Dyspnoea FatigueGastrointestinal symptoms 5 days prior to symptoms (suspected viral illness)Postural BP 104/82 to 120/79 mmHg Postural HR 121–150 bpmEchocardiogram normal ECG normalViral induced postural orthostatic tachycardia syndrome
43-year-old femalePalpitations Fatigue BreathlessnessUpper respiratory tract symptoms 1 month previously (suspected COVID-19)Postural BP 121/92 to 129/96 mmHg Postural HR 86–106 bpmAmbulatory BP monitor: average BP 101/66 mmHg 24-hour Holter: sinus rhythm, HRB 68–159, average 86 bpm. Diurnal sinus tachycardiaViral induced reactive tachycardia, with sympathetic overactivity
50-year-old femalePalpitations Chest painChesty cough March 2020 (suspected COVID-19)Postural BP 136/48 to 115/91 mmHg Postural HR 48–60 bpm24-hour Holter: sinus rhythm, rate 37–134 bpm, average 51 bpmPost viral orthostatic intolerance
30-year old femaleAches Dizziness Diarrhoea Dizziness and palpitationsFlu-like symptoms March 2020 (confirmed COVID-19)Postural HR 80–118 bpm Postural BP 112/79 to 123/103 mmHgHead-up tilt: starting BP 106/69 and HR 67 bpm, BP 72/52 mmHg and HR 99 bpm after 14 minutesPost viral orthostatic intolerance with reactive tachycardia
50-year-old femaleRecurrent presyncopal episodes Fatigue Panic attacksSuspected COVID-19 infection March 2020Postural HR 88–113 bpm Postural BP 137/85 mmHg to 122/88 mmHgEchocardiogram normal Ambulatory BP monitor: average 101/65 mmHg; Holter monitor: sinus tachycardia Head up tilt: postural drop of 17 mmHg and HR rise to 132 bpm after 24 minutesOrthostatic intolerance with a tendency to vasovagal presyncope
44-year-old femaleDizziness on walking Fatigue Irritable bowel symptoms AnxietyUpper respiratory tract symptoms for 5 weeks in March 2020 (suspected COVID-19)Telephone consultation so only readings from patient's BP monitor: 88/67 mmHgNilOrthostatic intolerance
  • BP = blood pressure; bpm = beats per minute; ECG = electrocardiogram; HR = heart rate.