Division of Cardiovascular Medicine, University of Toledo, Toledo, OH, USA.
Division of Cardiovascular Medicine, University of Toledo, Toledo, OH, USA.
Am J Med Sci. 2024 May;367(5):323-327. doi: 10.1016/j.amjms.2023.12.011. Epub 2024 Feb 8.
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.
最近有报道称，SARS-CoV-2 感染后会出现体位性心动过速综合征（POTS）和自主神经功能紊乱。自主神经功能紊乱的潜在机制尚不清楚。尚未研究这种病毒疾病对患有预先存在的 POTS 诊断的患者的潜在自主症状的影响。我们的研究旨在报告 COVID-19 感染对预先存在的 POTS 患者的影响，包括在疾病的急性期和恢复期。
获得机构审查委员会（IRB）的批准以访问研究对象的图表。所有在 2020 年 4 月至 2021 年 5 月期间感染 COVID-19 的已知患有 POTS 疾病的患者均被纳入研究。研究的终点是 POTS 相关症状恶化，包括感染 COVID-19 后直立性头晕、心悸、疲劳和晕厥/先兆晕厥，需要升级治疗。从回顾性图表中获得基本人口统计学资料、POTS 诊断详细信息、药物、有关 COVID-19 感染的其他信息、疾病持续时间、住院需求、POTS 症状恶化、需要急诊就诊、持续症状的类型和疫苗接种状况。
共研究了 41 名患者。α变体是引起 SARS-CoV-2 感染的最常见变体。其中 27%（11 名患者）的人新冠病毒检测呈阳性超过一次。大约 38 名（92.7%）患者报告在感染活跃期出现基线 POTS 症状恶化。大约 28 名患者（68%）在感染后至少 1-6 个月经历自主神经功能紊乱症状恶化。近 30 名患者（73.2%）需要额外的治疗来控制和改善症状。
患有预先存在的 POTS 的患者，大多数在感染 COVID-19 后经历了基线自主症状恶化，需要额外的药物治疗来改善症状。
