Johns Hopkins University School of Medicine, Department of Otolaryngology - Head and Neck Surgery, Baltimore, MD, USA.
Johns Hopkins Hospital and Children's Center, Department of Physical Medicine and Rehabilitation, Baltimore, MD, USA.
Int J Pediatr Otorhinolaryngol. 2024 Sep;184:112076. doi: 10.1016/j.ijporl.2024.112076. Epub 2024 Aug 22.
Patients with long-COVID suffer from symptoms that continue or develop after a COVID-19 or SARS-CoV-2 infection and are present for four or more weeks after the initial infection. This case series describes a group of previously healthy adolescent patients with long-COVID who were seen in a pediatric vestibular clinic for evaluation of severe dizziness and were diagnosed with persistent postural-perceptual dizziness (PPPD). By presenting their symptoms, management and treatment effects, this study aims to provide a diagnostic and therapeutic framework for providers who encounter these patients.
Patient records were reviewed for past medical history, symptoms, physical exam findings, results of audiometric and vestibular testing, dizziness handicap inventory for patient caregiver (DHI-pc) scores, and treatment recommendations. Parents of patients were contacted for a follow up survey to assess treatment adherence and outcomes including changes in symptoms and return to activity.
A series of 9 adolescent patients were referred from a multidisciplinary long-COVID clinic and diagnosed with PPPD. Recommended treatment included vestibular physical therapy, selective serotonin reuptake inhibitor medication, and cognitive behavioral therapy. The majority of patients experienced an improvement in their symptoms, and all patients had improved activity levels and DHI-pc scores after treatment.
To the best of our knowledge, no previous reports exist discussing PPPD in long-COVID patients. This case series provides insight into symptom evolution and treatment efficacy in this patient population.
长新冠患者在 COVID-19 或 SARS-CoV-2 感染后持续或出现新的症状，且在初始感染后持续 4 周以上。本病例系列描述了一组曾患有长新冠的先前健康的青少年患者，他们因严重头晕到儿科前庭诊所就诊，并被诊断为持续性姿势感知性头晕（PPPD）。通过呈现他们的症状、管理和治疗效果，本研究旨在为遇到这些患者的医生提供一个诊断和治疗框架。
回顾了患者的病历，包括既往病史、症状、体格检查结果、听力和前庭测试结果、患者照料者头晕残疾量表（DHI-pc）评分以及治疗建议。联系了患者的家长进行随访调查，以评估治疗依从性和结果，包括症状变化和恢复活动情况。
一系列 9 名青少年患者从多学科长新冠诊所转介过来，被诊断为 PPPD。推荐的治疗包括前庭物理疗法、选择性 5-羟色胺再摄取抑制剂药物和认知行为疗法。大多数患者的症状有所改善，所有患者在治疗后活动水平和 DHI-pc 评分均有所提高。
据我们所知，以前没有关于长新冠患者 PPPD 的报告。本病例系列提供了关于该患者群体症状演变和治疗效果的见解。
