Impact of COVID-19 infection on baseline autonomic symptoms in patients with preexisting Postural Tachycardia Syndrome and Orthostatic Intolerance: A retrospective study.

COVID 19 recovery in POTS patients COVID-19 inf on POTS Impact on baseline symptoms POTS and OI additional treatment

Journal

The American journal of the medical sciences
ISSN: 1538-2990
Titre abrégé: Am J Med Sci
Pays: United States
ID NLM: 0370506

Informations de publication

Date de publication:
08 Feb 2024
Historique:
received: 11 06 2023
revised: 07 11 2023
accepted: 06 12 2023
medline: 11 2 2024
pubmed: 11 2 2024
entrez: 10 2 2024
Statut: aheadofprint

Résumé

Postural orthostatic tachycardia syndrome (POTS) and dysautonomia following a SARS-CoV-2 infection have been recently reported. The underlying mechanism of dysautonomia is not well understood. The impact of this viral illness on the underlying autonomic symptoms has not been studied in patients with a pre-existing POTS diagnosis. Our study aims to report the impact of a COVID-19 infection on patients with preexisting POTS, both during the acute phase of the disease and post-recovery. Institutional Review Board (IRB) approval was obtained to access charts of the study subjects. All patients with known POTS disease who acquired COVID-19 infection between April 2020 and May 2021 were included. The end point of the study was worsening POTS related symptoms including orthostatic dizziness, palpitation, fatigue and syncope/ presyncope post COVID-19 infection that required escalation of therapy. Basic demographics, details of POTS diagnosis, medications, Additional information regarding COVID 19 infection, duration of illness, need for hospitalization, worsening of POTS symptoms, need for ED visits, the type of persisting symptoms and vaccination status were obtained from the retrospective chart review. A total of 41 patients were studied. The alpha-variant was the most common causing SARS-CoV-2 infection. 27% (11 patients) of them had tested positive for COVID- 19 infection more than once. About 38 (92.7%) of them reported having worsening of their baseline POTS symptoms during the active infection phase. About 28 patients (68 %) experienced worsening of their dysautonomia symptoms for at least 1-6 months post infection. Nearly 30 patients (73.2%) required additional therapy for their symptom control and improvement. Patients with pre-existing POTS, most experienced a worsening of their baseline autonomic symptoms after suffering the COVID-19 infection which required additional pharmacotherapy for their symptom improvement.

Sections du résumé

BACKGROUND BACKGROUND
Postural orthostatic tachycardia syndrome (POTS) and dysautonomia following a SARS-CoV-2 infection have been recently reported. The underlying mechanism of dysautonomia is not well understood. The impact of this viral illness on the underlying autonomic symptoms has not been studied in patients with a pre-existing POTS diagnosis. Our study aims to report the impact of a COVID-19 infection on patients with preexisting POTS, both during the acute phase of the disease and post-recovery.
METHODS METHODS
Institutional Review Board (IRB) approval was obtained to access charts of the study subjects. All patients with known POTS disease who acquired COVID-19 infection between April 2020 and May 2021 were included. The end point of the study was worsening POTS related symptoms including orthostatic dizziness, palpitation, fatigue and syncope/ presyncope post COVID-19 infection that required escalation of therapy. Basic demographics, details of POTS diagnosis, medications, Additional information regarding COVID 19 infection, duration of illness, need for hospitalization, worsening of POTS symptoms, need for ED visits, the type of persisting symptoms and vaccination status were obtained from the retrospective chart review.
RESULTS RESULTS
A total of 41 patients were studied. The alpha-variant was the most common causing SARS-CoV-2 infection. 27% (11 patients) of them had tested positive for COVID- 19 infection more than once. About 38 (92.7%) of them reported having worsening of their baseline POTS symptoms during the active infection phase. About 28 patients (68 %) experienced worsening of their dysautonomia symptoms for at least 1-6 months post infection. Nearly 30 patients (73.2%) required additional therapy for their symptom control and improvement.
CONCLUSIONS CONCLUSIONS
Patients with pre-existing POTS, most experienced a worsening of their baseline autonomic symptoms after suffering the COVID-19 infection which required additional pharmacotherapy for their symptom improvement.

Identifiants

pubmed: 38340983
pii: S0002-9629(24)01061-9
doi: 10.1016/j.amjms.2023.12.011
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of competing interest All authors have no conflict of interest to disclose

Auteurs

Chandramohan Meenakshisundaram (C)

Division of Cardiovascular Medicine, University of Toledo, Toledo, OH, USA.

Abdelmoniem Moustafa (A)

Division of Cardiovascular Medicine, University of Toledo, Toledo, OH, USA. Electronic address: Abdelmoniem.moustafa@utoledo.edu.

Meghana Ranabothu (M)

University of Toledo college of Medicine and life sciences, Toledo, OH, USA.

Ahmed Maraey (A)

Division of Cardiovascular Medicine, University of Toledo, Toledo, OH, USA.

Blair Grubb (B)

Division of Cardiovascular Medicine, University of Toledo, Toledo, OH, USA.

Classifications MeSH