Azkune-Galparsoro, H. (Harkaitz)

Search Results

Now showing 1 - 1 of 1
  • Thumbnail Image
    Dysautonomia in COVID-19 patients: a narrative review on clinical course, diagnostic and therapeutic strategies
    (2022) López-Bravo, A. (Alba); Gómez-Esteban, J.C. (Juan Carlos); Pozo, J.L. (José Luis) del; Carmona-Torre, F. (Francisco de A.); Mínguez-Olaondo, A. (Ane); Alcaide, A.B. (Ana Belén); Walcker, M. (Michaela); Azkune-Galparsoro, H. (Harkaitz); Tijero, B. (Beatriz); Grozeva, V. (Vesselina); Quiroga, J. (Jorge); Lopez-de-Munain, A. (Adolfo)
    IntroductionOn March 11, 2020, the World Health Organization sounded the COVID-19 pandemic alarm. While efforts in the first few months focused on reducing the mortality of infected patients, there is increasing data on the effects of long-term infection (Post-COVID-19 condition). Among the different symptoms described after acute infection, those derived from autonomic dysfunction are especially frequent and limiting. ObjectiveTo conduct a narrative review synthesizing current evidence of the signs and symptoms of dysautonomia in patients diagnosed with COVID-19, together with a compilation of available treatment guidelines. ResultsAutonomic dysfunction associated with SARS-CoV-2 infection occurs at different temporal stages. Some of the proposed pathophysiological mechanisms include direct tissue damage, immune dysregulation, hormonal disturbances, elevated cytokine levels, and persistent low-grade infection. Acute autonomic dysfunction has a direct impact on the mortality risk, given its repercussions on the respiratory, cardiovascular, and neurological systems. Iatrogenic autonomic dysfunction is a side effect caused by the drugs used and/or admission to the intensive care unit. Finally, late dysautonomia occurs in 2.5% of patients with Post-COVID-19 condition. While orthostatic hypotension and neurally-mediated syncope should be considered, postural orthostatic tachycardia syndrome (POTS) appears to be the most common autonomic phenotype among these patients. A review of diagnostic and treatment guidelines focused on each type of dysautonomic condition was done. ConclusionSymptoms deriving from autonomic dysfunction involvement are common in those affected by COVID-19. These symptoms have a great impact on the quality of life both in the short and medium to long term. A better understanding of the pathophysiological mechanisms of Post-COVID manifestations that affect the autonomic nervous system, and targeted therapeutic management could help reduce the sequelae of COVID-19, especially if we act in the earliest phases of the disease.