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.
【저자키워드】 COVID-19, SARS-CoV-2., Dysautonomia, Autonomic dysfunction, COMPASS-31, Orthostatic hypotension, 【초록키워드】 coronavirus disease, SARS-CoV-2, cross-sectional, Infection, Symptom, drug, COVID, Prevalence, Patient, nervous system, Mild, group, COVID-19 patients, Evidence, administration, dysfunction, domains, acute phase, statistical significance, domain, Study participants, total score, multivariate analyses, acute COVID-19, controls, described, performed, reported, the disease, form, significantly higher, Significant, assumed, autonomic, healthy volunteer, non-critically ill patient, orthostatic, 【제목키워드】 cross-sectional, COVID-19 patient, dysfunction, acute phase,