Prevalence and patterns of symptoms of dysautonomia in patients with long-COVID syndrome: A cross-sectional study

Ahmed M Eldokla, Aliae A Mohamed-Hussein, Ahmed M Fouad, Mariam G Abdelnaser, Sara T Ali, Nahed A Makhlouf, Islam G Sayed, Hoda A Makhlouf, Jaffer Shah, Hani Aiash, Ahmed M Eldokla, Aliae A Mohamed-Hussein, Ahmed M Fouad, Mariam G Abdelnaser, Sara T Ali, Nahed A Makhlouf, Islam G Sayed, Hoda A Makhlouf, Jaffer Shah, Hani Aiash

Abstract

Background: The association between autonomic dysfunction and long-COVID syndrome is established. However, the prevalence and patterns of symptoms of dysautonomia in long-COVID syndrome in a large population are lacking.

Objective: To evaluate the prevalence and patterns of symptoms of dysautonomia in patients with long-COVID syndrome.

Methods: We administered the Composite Autonomic Symptom Score 31 (COMPASS-31) questionnaire to a sample of post-COVID-19 patients who were referred to post-COVID clinic in Assiut University Hospitals, Egypt for symptoms concerning for long-COVID syndrome. Participants were asked to complete the COMPASS-31 questionnaire referring to the period of more than 4 weeks after acute COVID-19.

Results: We included 320 patients (35.92 ± 11.92 years, 73% females). The median COMPASS-31 score was 26.29 (0-76.73). The most affected domains of dysautonomia were gastrointestinal, secretomotor, and orthostatic intolerance with 91.6%, 76.4%, and 73.6%, respectively. There was a positive correlation between COMPASS-31 score and long-COVID duration (p < 0.001) and a positive correlation between orthostatic intolerance domain score and post-COVID duration (p < 0.001). There was a positive correlation between orthostatic intolerance domain score and age of participants (p = 0.004). Two hundred forty-seven patients (76.7%) had a high score of COMPASS-31 >16.4. Patients with COMPASS-31 >16.4 had a longer duration of long-COVID syndrome than those with score <16.4 (46.2 vs. 26.8 weeks, p < 0.001).

Conclusions: Symptoms of dysautonomia are common in long-COVID syndrome. The most common COMPASS-31 affected domains of dysautonomia are gastrointestinal, secretomotor, and orthostatic intolerance. There is a positive correlation between orthostatic intolerance domain score and patients' age.

© 2022 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.

Figures

Figure 1
Figure 1
Flowchart of the study population.
Figure 2
Figure 2
Correlation between age of participants and orthostatic intolerance domain weighted score of COMPASS.

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