Affiliation:
1. Department of General Internal Medicine St. Marianna University School of Medicine Kawasaki Kanagawa Japan
2. Department of Cardiology St. Marianna University School of Medicine Kawasaki Kanagawa Japan
3. Department of Virology & Parasitology, Graduate School of Medicine Osaka Metropolitan University Osaka Japan
4. Research Center for Infectious Disease Sciences, Graduate School of Medicine Osaka Metropolitan University Osaka Japan
5. Department of Gastroenterological and General Surgery St. Marianna University School of Medicine Kawasaki Kanagawa Japan
Abstract
AbstractBackgroundCoronavirus disease 2019 (COVID‐19) sequelae, also known as long COVID, can present with various symptoms. Among these symptoms, autonomic dysregulation, particularly postural orthostatic tachycardia syndrome (POTS), should be evaluated. However, previous studies on the treatment of POTS complicated by COVID‐19 are lacking. Therefore, this study aimed to investigate the treatment course of long COVID complicated by POTS.MethodsThe medical records of patients who complained of fatigue and met the criteria for POTS diagnosis were reviewed. We evaluated the treatment days, methods and changes in fatigue score, changes in heart rate on the Schellong test, and social situation at the first and last visits.ResultsThirty‐two patients with long COVID complicated by POTS were followed up (16 males; median age: 28 years). The follow‐up period was 159 days, and the interval between COVID‐19 onset and initial hospital attendance was 97 days. Some patients responded to β‐blocker therapy. Many patients had psychiatric symptoms that required psychiatric intervention and selective serotonin reuptake inhibitor prescription. Changes in heart rate, performance status, and employment/education status improved from the first to the last visit. These outcomes were believed to be because of the effects of various treatment interventions and spontaneous improvements.ConclusionsOur study suggests that the condition of 94% of patients with POTS complicated by long COVID will improve within 159 days. Therefore, POTS evaluation should be considered when patients with long COVID complain of fatigue, and attention should be paid to psychological symptoms and the social context.
Subject
Family Practice,Geriatrics and Gerontology,Internal Medicine
Reference33 articles.
1. World Health Organization (WHO) coronavirus (COVID‐19) dashboard.2022.https://covid19.who.int. Accessed 31 Jul 2023.
2. CDC.Long COVID or post‐COVID conditions.2022.https://www.cdc.gov/coronavirus/2019‐ncov/long‐term‐effects/index.html. Accessed 31 Jul 2023.
3. World Health Organization.A clinical case definition of post COVID‐19 condition by a Delphi consensus.2021.https://www.who.int/publications/i/item/WHO‐2019‐nCoV‐Post_COVID‐19_condition‐Clinical_case_definition‐2021.1. Accessed 31 Jul 2023.
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