Clinical characterization of dysautonomia in long COVID-19 patients

Abstract Increasing numbers of COVID-19 patients, continue to experience symptoms months after recovering from mild cases of COVID-19. Amongst these symptoms, several are related to neurological manifestations, including fatigue, anosmia, hypogeusia, headaches and hypoxia. However, the involvement o...

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Autores principales:	Nicolas Barizien, Morgan Le Guen, Stéphanie Russel, Pauline Touche, Florent Huang, Alexandre Vallée
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/df6a2bc754024006b902136f2de8ed3d
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spelling	oai:doaj.org-article:df6a2bc754024006b902136f2de8ed3d2021-12-02T18:33:56ZClinical characterization of dysautonomia in long COVID-19 patients10.1038/s41598-021-93546-52045-2322https://doaj.org/article/df6a2bc754024006b902136f2de8ed3d2021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-93546-5https://doaj.org/toc/2045-2322Abstract Increasing numbers of COVID-19 patients, continue to experience symptoms months after recovering from mild cases of COVID-19. Amongst these symptoms, several are related to neurological manifestations, including fatigue, anosmia, hypogeusia, headaches and hypoxia. However, the involvement of the autonomic nervous system, expressed by a dysautonomia, which can aggregate all these neurological symptoms has not been prominently reported. Here, we hypothesize that dysautonomia, could occur in secondary COVID-19 infection, also referred to as “long COVID” infection. 39 participants were included from December 2020 to January 2021 for assessment by the Department of physical medicine to enhance their physical capabilities: 12 participants with COVID-19 diagnosis and fatigue, 15 participants with COVID-19 diagnosis without fatigue and 12 control participants without COVID-19 diagnosis and without fatigue. Heart rate variability (HRV) during a change in position is commonly measured to diagnose autonomic dysregulation. In this cohort, to reflect HRV, parasympathetic/sympathetic balance was estimated using the NOL index, a multiparameter artificial intelligence-driven index calculated from extracted physiological signals by the PMD-200 pain monitoring system. Repeated-measures mixed-models testing group effect were performed to analyze NOL index changes over time between groups. A significant NOL index dissociation over time between long COVID-19 participants with fatigue and control participants was observed (p = 0.046). A trend towards significant NOL index dissociation over time was observed between long COVID-19 participants without fatigue and control participants (p = 0.109). No difference over time was observed between the two groups of long COVID-19 participants (p = 0.904). Long COVID-19 participants with fatigue may exhibit a dysautonomia characterized by dysregulation of the HRV, that is reflected by the NOL index measurements, compared to control participants. Dysautonomia may explain the persistent symptoms observed in long COVID-19 patients, such as fatigue and hypoxia. Trial registration: The study was approved by the Foch IRB: IRB00012437 (Approval Number: 20-12-02) on December 16, 2020.Nicolas BarizienMorgan Le GuenStéphanie RusselPauline ToucheFlorent HuangAlexandre ValléeNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Nicolas Barizien Morgan Le Guen Stéphanie Russel Pauline Touche Florent Huang Alexandre Vallée Clinical characterization of dysautonomia in long COVID-19 patients
description	Abstract Increasing numbers of COVID-19 patients, continue to experience symptoms months after recovering from mild cases of COVID-19. Amongst these symptoms, several are related to neurological manifestations, including fatigue, anosmia, hypogeusia, headaches and hypoxia. However, the involvement of the autonomic nervous system, expressed by a dysautonomia, which can aggregate all these neurological symptoms has not been prominently reported. Here, we hypothesize that dysautonomia, could occur in secondary COVID-19 infection, also referred to as “long COVID” infection. 39 participants were included from December 2020 to January 2021 for assessment by the Department of physical medicine to enhance their physical capabilities: 12 participants with COVID-19 diagnosis and fatigue, 15 participants with COVID-19 diagnosis without fatigue and 12 control participants without COVID-19 diagnosis and without fatigue. Heart rate variability (HRV) during a change in position is commonly measured to diagnose autonomic dysregulation. In this cohort, to reflect HRV, parasympathetic/sympathetic balance was estimated using the NOL index, a multiparameter artificial intelligence-driven index calculated from extracted physiological signals by the PMD-200 pain monitoring system. Repeated-measures mixed-models testing group effect were performed to analyze NOL index changes over time between groups. A significant NOL index dissociation over time between long COVID-19 participants with fatigue and control participants was observed (p = 0.046). A trend towards significant NOL index dissociation over time was observed between long COVID-19 participants without fatigue and control participants (p = 0.109). No difference over time was observed between the two groups of long COVID-19 participants (p = 0.904). Long COVID-19 participants with fatigue may exhibit a dysautonomia characterized by dysregulation of the HRV, that is reflected by the NOL index measurements, compared to control participants. Dysautonomia may explain the persistent symptoms observed in long COVID-19 patients, such as fatigue and hypoxia. Trial registration: The study was approved by the Foch IRB: IRB00012437 (Approval Number: 20-12-02) on December 16, 2020.
format	article
author	Nicolas Barizien Morgan Le Guen Stéphanie Russel Pauline Touche Florent Huang Alexandre Vallée
author_facet	Nicolas Barizien Morgan Le Guen Stéphanie Russel Pauline Touche Florent Huang Alexandre Vallée
author_sort	Nicolas Barizien
title	Clinical characterization of dysautonomia in long COVID-19 patients
title_short	Clinical characterization of dysautonomia in long COVID-19 patients
title_full	Clinical characterization of dysautonomia in long COVID-19 patients
title_fullStr	Clinical characterization of dysautonomia in long COVID-19 patients
title_full_unstemmed	Clinical characterization of dysautonomia in long COVID-19 patients
title_sort	clinical characterization of dysautonomia in long covid-19 patients
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/df6a2bc754024006b902136f2de8ed3d
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Clinical characterization of dysautonomia in long COVID-19 patients

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