Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Trieste University Hospital-ASUGI, University of Trieste, Strada di Fiume, 447, 34149, Trieste, Italy.
School of Medicine and Surgery, Department of Medicine, Surgery and Health Sciences, Trieste University Hospital-ASUGI, University of Trieste, Strada di Fiume, 447, 34149, Trieste, Italy.
J Neurol. 2022 Feb;269(2):587-596. doi: 10.1007/s00415-021-10735-y. Epub 2021 Aug 12.
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.
自主神经系统(ANS)可能会受到 COVID-19 的影响,而自主神经功能障碍可能是 COVID-19 后个体的一种潜在并发症。体位性低血压(OH)和姿势性心动过速综合征(POTS)在 SARS-CoV-2 感染后被认为很常见,但 ANS 功能的其他组成部分也可能受损。综合自主症状量表 31 项(COMPASS-31)问卷是一种评估自主神经症状的简单且经过验证的工具。本研究的目的是向有和无神经系统症状的 COVID-19 后患者样本中使用 COMPASS-31 问卷。参与者是在 COVID-19 症状出现后 4 周到 9 个月期间从 COVID-19 门诊服务中招募的,进行后续评估。参与者被要求在 COVID-19 疾病后填写 COMPASS-31 问卷。为了诊断 OH 和 POTS,在主动站立测试期间手动测量心率和血压。共有 180 名参与者被纳入分析(70.6%为女性,51±13 岁),13.8%的患者存在 OH。COMPASS-31 评分中位数为 17.6(6.9-31.4),受影响最严重的领域是直立不耐受、汗腺、胃肠道和瞳孔运动功能障碍。有神经系统症状的患者的 COMPASS-31 评分较高(p<0.01),这是由于更严重的直立不耐受症状(p<0.01),尽管胃肠道(p<0.01)、尿(p<0.01)和瞳孔运动(p<0.01)方面在无神经系统症状组中更为明显。本研究证实了监测自主神经系统症状作为 COVID-19 疾病的一种潜在并发症的重要性,这种症状可能会在急性后期持续存在。
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