Schofield Jill R
University of Colorado School of Medicine, Aurora, Colorado, USA.
Eur J Case Rep Intern Med. 2021 Mar 22;8(3):002378. doi: 10.12890/2021_002378. eCollection 2021.
This is the first case report of a patient with post-COVID-19 postural orthostatic tachycardia syndrome (POTS) with multiple persistent antiphospholipid antibody (aPL)-positivity more than a year after illness onset who also meets Global Consensus-2 criteria for mast cell activation syndrome (MCAS), suggesting pathological activation of the acquired and innate immune systems by SARS-CoV-2. While the patient continues to meet criteria for POTS 1 year on, her functional ability has improved significantly with therapy directed at MCAS, POTS and aPL-positivity.
A subset of long-haul COVID-19 patients have postural orthostatic tachycardia syndrome (POTS), which can be diagnosed by a 10-minute in-office stand test.Antiphospholipid antibodies may be associated with POTS in patients with long-haul COVID-19 and have important clinical implications.Mast cell activation syndrome (MCAS) may be associated with long-haul COVID-19 (with or without POTS) and can often be easily treated, including with over-the-counter medications, supplements and dietary changes.
这是首例关于新型冠状病毒肺炎（COVID-19）后体位性直立性心动过速综合征（POTS）患者的病例报告，该患者在发病一年多后多次持续出现抗磷脂抗体（aPL）阳性，且符合肥大细胞活化综合征（MCAS）的全球共识-2标准，提示严重急性呼吸综合征冠状病毒2（SARS-CoV-2）对获得性和先天性免疫系统的病理性激活。虽然该患者在患病1年后仍符合POTS标准，但通过针对MCAS、POTS和aPL阳性的治疗，其功能能力有了显著改善。
一部分新冠长期康复患者患有体位性直立性心动过速综合征（POTS），可通过10分钟的门诊站立试验进行诊断。抗磷脂抗体可能与新冠长期康复患者的POTS相关，具有重要的临床意义。肥大细胞活化综合征（MCAS）可能与新冠长期康复（无论有无POTS）相关，且通常易于治疗，包括使用非处方药物、补充剂和饮食改变。
