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

tetano

Editor, Senior Moderator
Neurol Sci


. 2022 May 24.
doi: 10.1007/s10072-022-06136-2. Online ahead of print.
Autonomic dysfunction in non-critically ill COVID-19 patients during the acute phase of disease: an observational, cross-sectional study


Irene Scala[SUP] #[/SUP][SUP] 1 [/SUP], Simone Bellavia[SUP] #[/SUP][SUP] 1 [/SUP], Marco Luigetti[SUP] 2 [/SUP], Valerio Brunetti[SUP] 3 [/SUP], Aldobrando Broccolini[SUP] 1 3 [/SUP], Maurizio Gabrielli[SUP] 4 [/SUP], Lorenzo Zileri Dal Verme[SUP] 5 [/SUP], Paolo Calabresi[SUP] 1 3 [/SUP], Giacomo Della Marca[SUP] 1 3 [/SUP], Giovanni Frisullo[SUP] 3 [/SUP]



Affiliations

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.
 
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