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长期新冠患者:直立性心动过速综合征的患病率降低,但随着病程延长,脑血流异常仍持续存在。

Long-Haul COVID Patients: Prevalence of POTS Are Reduced but Cerebral Blood Flow Abnormalities Remain Abnormal with Longer Disease Duration.

作者信息

Campen C Linda M C van, Visser Frans C

机构信息

Stichting Cardiozorg, Planetenweg 5, 2132 HN Hoofddorp, The Netherlands.

出版信息

Healthcare (Basel). 2022 Oct 21;10(10):2105. doi: 10.3390/healthcare10102105.

Abstract

Background: Postural orthostatic tachycardia syndrome (POTS) has been described early after the onset of the COVID-19 infection, but also orthostatic hypotension (OH). In the present study, we hypothesized that orthostatic intolerance decreases over time. Methods: In 29 long-haul COVID-19 (LHC) patients, a tilt test was performed, including measurements of cerebral blood flow (CBF) by extracranial Doppler. The time interval between the onset of infection and the tilt test varied between 3 and 28 months. Results: In the first 12 months after the infection, 71% of the LHC patients showed POTS and after 24 months none of them. In the first 12 months, 29% of patients had a normal heart rate and blood pressure response (normHRBP) and after 24 months 75% (distribution of POTS, OH, and a normHRBP over time: p < 0.0001). Linear regression showed that, over time, there was a decrease in the abnormal CBF during the tilt (p = 0.024) but remained abnormal. Conclusion: In LHC patients, hemodynamic abnormalities of a tilt test change over time. Patients studied early after the onset of the disease mainly exhibit POTS, but patients studied later in the time course mainly show a normHRBP or OH. In addition, the abnormal CBF reduction improves over time, but CBF remains abnormal.

摘要

背景

在新型冠状病毒肺炎(COVID-19)感染发病后早期就已发现体位性直立性心动过速综合征(POTS),但也有体位性低血压(OH)的报道。在本研究中,我们假设体位不耐受会随时间降低。方法:对29例新冠长期后遗症(LHC)患者进行了倾斜试验,包括通过颅外多普勒测量脑血流量(CBF)。感染发病至倾斜试验的时间间隔在3至28个月之间。结果:在感染后的前12个月,71%的LHC患者表现为POTS,而在24个月后无一人出现。在最初的12个月,29%的患者心率和血压反应正常(正常HRBP),24个月后这一比例为75%(POTS、OH和正常HRBP随时间的分布:p<0.0001)。线性回归显示,随着时间推移,倾斜期间异常CBF有所下降(p=0.024),但仍为异常。结论:在LHC患者中,倾斜试验的血流动力学异常随时间变化。疾病发病后早期研究的患者主要表现为POTS,但病程后期研究的患者主要表现为正常HRBP或OH。此外,异常CBF降低随时间有所改善,但CBF仍为异常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/819c/9602558/c3e0cdcec591/healthcare-10-02105-g001.jpg

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