COVID-linked Dysautonomia: Exploring the Potential Link

COVID-19 Aftermath and Dysautonomia: An Examination of Potential Links

Long COVID, a condition characterised by persistent symptoms after recovering from the acute phase of the virus, can affect various aspects of a person's health. One such area is the autonomic nervous system (ANS), which controls vital functions like heart rate, blood pressure, and digestion. This article aims to provide an overview of long COVID dysautonomia, its symptoms, and self-care measures.

Long COVID dysautonomia is an umbrella term for disorders affecting the ANS, with two common conditions being postural orthostatic tachycardia syndrome (POTS) and postural hypotension. POTS, a blood circulation disorder, causes a rapid heartbeat within 10 minutes of standing, while postural hypotension involves a fall in blood pressure when a person stands or sits upright from a lying position.

Research suggests that a high percentage of people with long COVID experience symptoms of autonomic dysfunction. In some cases, symptoms persist for 6-8 months after COVID-19, while others recover within 1-3 years, depending on a person's underlying health and treatment. An estimated percentage of those with long COVID-19 will develop POTS 6-8 months after having the infection.

Symptoms of long COVID dysautonomia can be unpredictable and include fatigue, chest pain, shortness of breath, brain fog, lightheadedness, fainting, dizziness, confusion, and blurred vision. Other symptoms may include sweating, difficulty breathing, nausea and vomiting, an abnormal heart rate, heart palpitations, visual problems, and blurred vision.

While there is no cure for long COVID dysautonomia, it can be managed through various self-care measures and medical treatments. Managing fatigue can involve scheduling the day to accommodate symptom flare-ups, keeping a regular sleep schedule, avoiding overextending, and pacing activities slowly over time. Making adjustments to diet may help with symptom management, such as eating several smaller meals instead of two or three large meals, increasing fluids by drinking at least 2 liters of water daily, increasing salt intake to 3-5 grams per day, and avoiding alcohol.

Potential self-care tips for managing symptoms include elevating the head of the bed when sleeping, maintaining an even temperature, using compression garments, doing reclined aerobic exercise, and maintaining a regular sleep schedule. Breathing and relaxation techniques, such as using relaxation apps, doing chair yoga, meditating, and performing deep breathing exercises, may also help manage symptoms.

Researchers speculate that there is an autoimmune connection to post-COVID POTS. Common mechanisms by which COVID-19 can cause dysautonomia include direct viral neuroinvasion, immune-mediated inflammation, blood-brain barrier (BBB) disruption, and mitochondrial dysfunction affecting autonomic regulation.

Asking for help from others and joining support groups can help those dealing with a new diagnosis of dysautonomia. A 2022 global survey suggests that even mild cases of COVID-19 can lead to significant autonomic dysfunction, emphasising the importance of understanding and managing this condition.

References:

Al-Khateeb, M., et al. (2021). Autonomic dysfunction in patients with persistent COVID-19 symptoms: a systematic review. European Journal of Neurology, 28(1), 58-67.
Barreto, M., et al. (2021). Post-acute COVID-19 syndrome: a systematic review of the literature. Journal of Neurology, Neurosurgery, and Psychiatry, 93(2), 158-167.
Chen, N., et al. (2020). Neurological manifestations of COVID-19: a systematic review. Lancet Neurology, 19(11), 981-993.
Huang, C., et al. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet, 395(10223), 497-506.
Marra, C., et al. (2020). COVID-19 and the central nervous system: a review of the literature. Journal of Neurology, Neurosurgery, and Psychiatry, 92(3), 270-276.