Background The association between autonomic dysfunction and long‐COVID syndrome is established. However, the prevalence and patterns of symptoms of dysautonomia in long‐COVID syndrome in a large population are lacking. Objective To evaluate the prevalence and patterns of symptoms of dysautonomia in patients with long‐COVID syndrome. Methods We administered the Composite Autonomic Symptom Score 31 (COMPASS‐31) questionnaire to a sample of post‐COVID‐19 patients who were referred to post‐COVID clinic in Assiut University Hospitals, Egypt for symptoms concerning for long‐COVID syndrome. Participants were asked to complete the COMPASS‐31 questionnaire referring to the period of more than 4 weeks after acute COVID‐19. Results We included 320 patients (35.92 ± 11.92 years, 73% females). The median COMPASS‐31 score was 26.29 (0–76.73). The most affected domains of dysautonomia were gastrointestinal, secretomotor, and orthostatic intolerance with 91.6%, 76.4%, and 73.6%, respectively. There was a positive correlation between COMPASS‐31 score and long‐COVID duration ( p < 0.001) and a positive correlation between orthostatic intolerance domain score and post‐COVID duration ( p < 0.001). There was a positive correlation between orthostatic intolerance domain score and age of participants ( p = 0.004). Two hundred forty‐seven patients (76.7%) had a high score of COMPASS‐31 >16.4. Patients with COMPASS‐31 >16.4 had a longer duration of long‐COVID syndrome than those with score <16.4 (46.2 vs. 26.8 weeks, p < 0.001). Conclusions Symptoms of dysautonomia are common in long‐COVID syndrome. The most common COMPASS‐31 affected domains of dysautonomia are gastrointestinal, secretomotor, and orthostatic intolerance. There is a positive correlation between orthostatic intolerance domain score and patients' age.
This study aims to explore the prevalence of anosmia and dysgeusia and their impact on COVID-19 patients. Methods: This is a cross-sectional study. Patients diagnosed with COVID-19 between 1st October 2020 and 30th June 2021 were randomly selected from a national COVID-19 registry. COVID-19 cases were diagnosed using molecular testing method which measured the viral E gene. The Anosmia Reporting Tool, and a brief version of the questionnaire on olfactory disorders were used to measure the outcomes via telephone interviews. Data were analysed using SPSS 27 statistics software. Results: A total of 405 COVID-19 adults were included in this study, 220 (54.3%) were males and 185 (45.8%) were females. The mean±SD age of participants was 38.2 ± 11.3 years. Alterations in the sense of smell and taste were reported by 206 (50.9%), and 195 (48.1%) of the patients, respectively. Sex and nationality of participants were significantly associated with anosmia and dysgeusia (p < 0.001) and (p-value=0.001) respectively. Among patients who experienced anosmia and dysgeusia, alterations in eating habits (64.2%), impact on mental wellbeing (38.9%), concerns that the alterations were permanent (35.4%), and physical implications and difficulty performing activities of daily living (34%) were reported. Conclusion: Anosmia and dysgeusia are prevalent symptoms of COVID-19 disease, especially among females. Although transient, anosmia and dysgeusia had considerable impact on patient's life. Neuropsychological implications of COVID-19 in acute infection phase and prognosis of anosmia and dysgeusia in COVID-19 are areas for further exploration.
Background Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects many organs of the body including the peripheral nervous system (PNS) which has potential significant impact. Plexopathy is rare but one of the serious PNS manifestations of lupus. Case A 41-year-old female presented with recurrent attacks of painful brachial plexopathy and right hemi-diaphragmatic paralysis. After extensive workup, she was diagnosed with SLE and started on hydroxychloroquine and mycophenolate mofetil. The frequency and severity of the attacks of plexopathy has significantly improved after starting the immune suppressive therapy for SLE. Whole exome sequencing unveiled previously unreported mutations encoding non-synonymous amino acids in titin and minichromosome maintenance 3-associated protein. Conclusion Recurrent attacks of painful brachial plexopathy may warrant careful evaluation for underlying SLE with a premise of therapeutic benefit.
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