Autonomic Manifestations of Long-COVID Syndrome

Curr Neurol Neurosci Rep. 2023 Dec;23(12):881-892. doi: 10.1007/s11910-023-01320-z. Epub 2023 Nov 10.

Abstract

Purpose of review: Long-COVID is a novel condition emerging from the COVID-19 pandemic. Long-COVID is characterized by symptoms commonly seen in autonomic disorders including fatigue, brain fog, light-headedness, and palpitations. This article will critically evaluate recent findings and studies on Long-COVID and its physiological autonomic manifestations.

Recent findings: Studies have reported on the prevalence of different symptoms and autonomic disorders in Long-COVID cohorts. Autonomic nervous system function, including both the parasympathetic and sympathetic limbs, has been studied using different testing techniques in Long-COVID patients. While numerous mechanisms may contribute to Long-COVID autonomic pathophysiology, it is currently unclear which ones lead to a Long-COVID presentation. To date, studies have not tested treatment options for autonomic disorders in Long-COVID patients. Long-COVID is associated with autonomic abnormalities. There is a high prevalence of clinical autonomic disorders among Long-COVID patients, with limited knowledge of the underlying mechanisms and the effectiveness of treatment options.

Keywords: Autonomic dysfunction; Heart rate variability; Initial orthostatic hypotension; Long-COVID syndrome; Orthostatic hypotension; Postural orthostatic tachycardia syndrome.

Publication types

  • Review
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autonomic Nervous System
  • Autonomic Nervous System Diseases* / epidemiology
  • Autonomic Nervous System Diseases* / etiology
  • COVID-19* / complications
  • COVID-19* / epidemiology
  • Humans
  • Pandemics
  • Post-Acute COVID-19 Syndrome
  • Postural Orthostatic Tachycardia Syndrome* / diagnosis
  • Postural Orthostatic Tachycardia Syndrome* / epidemiology