Dysautonomia following COVID-19 is not associated with subjective limitations or symptoms but is associated with objective functional limitations.
Heart Rhythm
; 19(4): 613-620, 2022 04.
Article
in English
| MEDLINE | ID: covidwho-1560871
ABSTRACT
BACKGROUND:
Individuals who contract coronavirus disease 2019 (COVID-19) can suffer with persistent and debilitating symptoms long after the initial acute illness. Heart rate (HR) profiles determined during cardiopulmonary exercise testing (CPET) and delivered as part of a post-COVID recovery service may provide insight into the presence and impact of dysautonomia on functional ability.OBJECTIVE:
Using an active, working-age, post-COVID-19 population, the purpose of this study was to (1) determine and characterize any association between subjective symptoms and dysautonomia; and (2) identify objective exercise capacity differences between patients classified "with" and those "without" dysautonomia.METHODS:
Patients referred to a post-COVID-19 service underwent comprehensive clinical assessment, including self-reported symptoms, CPET, and secondary care investigations when indicated. Resting HR >75 bpm, HR increase with exercise <89 bpm, and HR recovery <25 bpm 1 minute after exercise were used to define dysautonomia. Anonymized data were analyzed and associations with symptoms, and CPET outcomes were determined.RESULTS:
Fifty-one of the 205 patients (25%) reviewed as part of this service evaluation had dysautonomia. There were no associations between symptoms or perceived functional limitation and dysautonomia (P >.05). Patients with dysautonomia demonstrated objective functional limitations with significantly reduced work rate (219 ± 37 W vs 253 ± 52 W; P <.001) and peak oxygen consumption (VÌo2 30.6 ± 5.5 mL/kg/min vs 35.8 ± 7.6 mL/kg/min; P <.001); and a steeper (less efficient) VÌe/VÌco2 slope (29.9 ± 4.9 vs 27.7 ± 4.7; P = .005).CONCLUSION:
Dysautonomia is associated with objective functional limitations but is not associated with subjective symptoms or limitation.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Primary Dysautonomias
/
COVID-19
/
Heart Failure
Type of study:
Diagnostic study
/
Experimental Studies
/
Prognostic study
Topics:
Long Covid
Limits:
Humans
Language:
English
Journal:
Heart Rhythm
Year:
2022
Document Type:
Article
Affiliation country:
J.hrthm.2021.12.005
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