Autonomic dysfunction syndrome in patients with consequences of a new coronavirus infection in outpatient practice

Purpose of the study: to analyze the clinical manifestations of autonomic dysfunction syndrome in patients who have recovered from COVID-19 of varying severity.

Material and methods. An outpatient examination was conducted on 45 patients (26 women, 19 men) who had recovered from COVID-19 within 3 to 6 months prior to the examination. The average age of the patients was 58 years [26; 73]. Inclusion criteria were a confirmed PCR test for COVID-19 from 3 to 6 months after the onset of the disease. Exclusion criteria included severe cerebrovascular or cardiovascular pathology that complicated necessary measurements and severe somatic conditions of the patients. All patients underwent electrocardiographic examination (ECG), an orthostatic test, calculation of the Kerdo autonomic index (KAI), and assessment for signs of autonomic disturbances using A.M. Vein’s questionnaire (1998).

Results and conclusion. During the orthostatic test, a statistically significant decrease in systolic blood pressure (SBP) was observed, more pronounced in patients who had experienced severe (p < 0.05) and moderate (p < 0.01) forms of the new coronavirus infection. Orthostatic hypotension was noted in 76 ± 0.18% of the examined patients. A statistically significant greater increase in heart rate during the orthostatic test was observed in patients who had suffered from severe and moderate forms of the new coronavirus infection (p < 0.05). A statistically significant lower value of the KAI was found in patients who had experienced moderate and severe COVID-19 compared to those with mild forms of the infection (p < 0.01 and p < 0.05, respectively). Signs of autonomic dysfunction were identified in 82 ± 0.15% of the examined patients, with a direct correlation of moderate strength established between the severity of autonomic disorders and the degree of severity of COVID-19 (p < 0.01). The consequences of the new coronavirus infection in the form of autonomic dysfunction persist for an extended period — up to 6 months or longer. The core clinical picture of autonomic disorders in these patients consists of symptoms of peripheral autonomic insufficiency.

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