Autonomic dysfunction in non-critically ill COVID-19 patients during the acute phase of disease: an observational, cross-sectional study

Irene Scala, Simone Bellavia, Marco Luigetti, Valerio Brunetti, Aldobrando Broccolini, Maurizio Gabrielli, Lorenzo Zileri Dal Verme, Paolo Calabresi, Giacomo Della Marca, Giovanni Frisullo, Irene Scala, Simone Bellavia, Marco Luigetti, Valerio Brunetti, Aldobrando Broccolini, Maurizio Gabrielli, Lorenzo Zileri Dal Verme, Paolo Calabresi, Giacomo Della Marca, Giovanni Frisullo

Abstract

Introduction: Evidence is emerging about an extra-pulmonary involvement of SARS-CoV-2, including the nervous system. Autonomic dysfunction in patients recovering from acute coronavirus disease 2019 (COVID-19) has been recently described. Dysautonomic symptoms have been reported in the acute phase of the disease, but clear evidence is lacking, especially in the non-critical forms of the infection.

Objective: The aim of this study is to assess the prevalence of dysautonomia in acute, non-critically ill COVID-19 patients.

Methods: In this observational, cross-sectional study, we compared 38 non-critically ill patients with acute COVID-19 (COVID + group) to 38 healthy volunteers (COVID - group) in order to assess the prevalence of signs and symptoms of dysautonomia through the administration of the composite autonomic symptom score 31 (COMPASS-31) and an active standing test. Comparisons between groups were performed by means of both univariate and multivariate analyses.

Results: The prevalence of orthostatic hypotension was significantly higher in the COVID + group. Higher total scores of COMPASS-31 were observed in the COVID + group than controls. Significant differences between groups emerged in the secretomotor, orthostatic intolerance, and gastrointestinal COMPASS-31 domains. All these results maintained the statistical significance after the adjustment for concomitant drugs with a known effect on the autonomic nervous system assumed by the study participants, except for the differences in the gastrointestinal domain of COMPASS-31.

Conclusion: Our results suggest that an autonomic dysfunction could be an early manifestation of COVID-19, even in the contest of mild forms of the infection.

Keywords: Autonomic dysfunction; COMPASS-31; COVID-19; Dysautonomia; Orthostatic hypotension; SARS-CoV-2.

Conflict of interest statement

The authors declare no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Flow diagram depicting the study enrolment process (COVID + group). Abbreviations: COVID, coronavirus disease 2019

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Source: PubMed

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