Chadda Karan R, Blakey Ellen E, Huang Christopher L-H, Jeevaratnam Kamalan
Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
Physiological Laboratory, University of Cambridge, Cambridge, United Kingdom.
Front Cardiovasc Med. 2022 Mar 9;9:860198. doi: 10.3389/fcvm.2022.860198. eCollection 2022.
While the increased arrhythmic tendency during acute COVID-19 infection is recognised, the long-term cardiac electrophysiological complications are less well known. There are a high number of patients reporting ongoing symptoms post-infection, termed long COVID. A recent hypothesis is that long COVID symptoms could be attributed to dysautonomia, defined as malfunction of the autonomic nervous system (ANS). The most prevalent cardiovascular dysautonomia amongst young people is postural orthostatic tachycardia syndrome (POTS). Numerous reports have described the development of POTS as part of long COVID. Possible underlying mechanisms, although not mutually exclusive or exhaustive, include hypovolaemia, neurotropism, inflammation and autoimmunity. Treatment options for POTS and other long COVID symptoms are currently limited. Future research studies should aim to elucidate the underlying mechanisms of dysautonomia to enable the development of targeted therapies. Furthermore, it is important to educate healthcare professionals to recognise complications and conditions arising from COVID-19, such as POTS, to allow prompt diagnosis and access to early treatment.
虽然急性新冠病毒感染期间心律失常倾向增加已得到认可,但长期心脏电生理并发症却鲜为人知。有大量患者报告感染后仍有持续症状,即所谓的“长新冠”。最近的一种假说认为,“长新冠”症状可能归因于自主神经功能障碍,即自主神经系统(ANS)功能失常。年轻人中最常见的心血管自主神经功能障碍是体位性直立性心动过速综合征(POTS)。众多报告将POTS的发生描述为“长新冠”的一部分。可能的潜在机制虽非相互排斥或详尽无遗,但包括血容量不足、神经嗜性、炎症和自身免疫。目前,POTS和其他“长新冠”症状的治疗选择有限。未来的研究应旨在阐明自主神经功能障碍的潜在机制,以便开发针对性疗法。此外,教育医疗保健专业人员认识新冠病毒感染引起的并发症和病症,如POTS,以便能够及时诊断并获得早期治疗,这一点很重要。
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