Acute hyperhidrosis and postural tachycardia in a COVID-19 patient

Umapathi, Thirugnanam; Poh, Mervyn Qi Wei; Fan, Bingwen Eugene; Li, Ki Fung Cliff; George, Julie; Tan, J.

doi:10.1007/s10286-020-00733-x

Cited by 59 publications

(55 citation statements)

References 5 publications

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“…Furthermore, it is possible that the anti-SARS-CoV2 antibodies might have an autoimmune basis as they cross-react with the receptors in the ganglia [16]. Another case study found POTS in a SARS-CoV2 patient hypothesized that the virus reduces the ACE2 receptor when it binds and consequently increased sympathetic activity [17]. Given the nature of the aforementioned study findings, it is important to look at how COVID-19 and POTS are related.…”

Section: Discussionmentioning

confidence: 97%

A Case of Postural Orthostatic Tachycardia Syndrome Secondary to the Messenger RNA COVID-19 Vaccine

Reddy¹,

Reddy²,

Arora³

2021

Cureus

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Postural orthostatic tachycardia syndrome (POTS) is an impaction of the autonomic nervous system initiating orthostatic tachycardia. There are numerous triggers for POTS including viruses, vaccines, and an autoimmune basis. This case report is clinically relevant to better understand the pathophysiology behind the messenger RNA (mRNA) coronavirus disease 2019 (COVID-19) vaccine and the mechanism that triggers autonomic nervous system dysfunction. Furthermore, the overall goal of this case study is to report a unique side effect associated with the novel mRNA COVID-19 vaccine. A 42-year-old male, with no prior symptoms of sinus tachycardia and presyncope episodes, is diagnosed with POTS secondary to the first dose of the mRNA COVID-19 vaccine. Symptoms to this date include sinus tachycardia, dizziness, headaches, and fatigue that are often triggered after a large meal or standing for a longer duration. Numerous diagnostic tests and images failed to confirm any other diagnosis other than POTS. There was a sequential connection between the onset of symptoms approximately one week after taking the first dose of the mRNA COVID-19 vaccine. Currently, POTS in this patient is controlled by lifestyle modification. This case report has broader implications as it can help us understand how the mRNA vaccine works on the body relative to the immune system. Our theory is that the development of antibodies activates an autoimmune reaction that triggers POTS disease. The prevalence of the POTS dysautonomia post-vaccination will be clearer as more data and research are conducted on the side effects from the innovative mRNA vaccines created to combat severe acute respiratory syndrome coronavirus 2.

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Section: Discussionmentioning

confidence: 97%

A Case of Postural Orthostatic Tachycardia Syndrome Secondary to the Messenger RNA COVID-19 Vaccine

Reddy¹,

Reddy²,

Arora³

2021

Cureus

View full text Add to dashboard Cite

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“…This syndrome develops after acute stress factors, such as viral illness [ 19 – 21 ]. Therefore, dysautonomia, including postural tachycardia, has been determined in patients with COVID-19 [ 4 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Autonomic dysfunction detection by an automatic pupillometer as a non-invasive test in patients recovered from COVID-19

Karahan

Demirtaş

Hazar

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Purpose To recognize dysfunctions in the autonomic nervous system (ANS) with changes in dynamic and static pupillary responses in patients who recovered from coronavirus disease-2019 (COVID-19) Methods One month after recovery from COVID-19, patients were subjected to eye examinations. Pupillary responses were measured using a pupillometry system. Dynamic pupil parameters (i.e., pupil contraction amplitude, pupil dilatation latency, pupil contraction latency, pupil dilatation duration, pupil dilatation velocity, pupil contraction duration, pupil contraction velocity, resting pupil diameter [PD]) and static pupil parameters (i.e., mesopic PD, scotopic PD, high photopic PD, and low photopic PD) were registered. Results Although high photopic and scotopic PDs were significantly higher in patients recovering from COVID-19 than in healthy controls ( P = 0.04 and P = 0.002), no statistically significant difference was found in mesopic and low photopic PD ( P = 0.19 and P = 0.41). Regarding dynamic pupillometry parameters, resting PD and pupil contraction velocity ( P = 0.04 and P = 0.02, respectively) were significantly higher in patients recovering from COVID-19 than in healthy controls ( P < 0.001 and P < 0.001, respectively), whereas pupil dilatation latency and pupil contraction duration were lower in these patients than in healthy controls ( P = 0.01 and P = 0.008, respectively). No significant differences in pupil contraction amplitude, pupil dilatation duration, pupil contraction latency, and pupil dilatation velocity were found between the study groups ( P = 0.93, P = 0.91, P = 0.42, and P = 0.48, respectively). Conclusion Pupil responses, which are controlled by the ANS, were impaired in patients recovering from COVID-19. Pupillometry shows promise as a non-invasive, easy-to-apply diagnostic technology for detecting autonomic dysfunction in patients recovering from COVID-19. Clinical trial registration Not applicable.

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“…These symptoms, when combined with excessive orthostatic tachycardia, can lead to a diagnosis of postural tachycardia syndrome (POTS) post-COVID-19 [6]. Recently, a number of case reports have been published describing patients who developed POTS following a SARS-CoV-2 infection [7][8][9]. Anecdotal preliminary information from personal communications with autonomic clinics in the USA, UK and Canada suggest an increased incidence of POTS, with independent articles in the Wall Street Journal [10], The New York Times [11], and The Atlantic [12].…”

Section: Long-covid Potsmentioning

confidence: 99%

Long-COVID postural tachycardia syndrome: an American Autonomic Society statement

et al. 2021

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COVID-19 is a global pandemic that has had a devastating effect on the health and economy of much of human civilization. While the acute impacts of COVID-19 were the initial focus of concern, it is becoming clear that in the wake of COVID-19, many patients are developing chronic symptoms that have been called Long-COVID. Some of the symptoms and signs include those of postural tachycardia syndrome (POTS). Understanding and managing long-COVID POTS will require a significant infusion of health care resources and a significant additional research investment. In this document from the American Autonomic Society, we outline the scope of the problem, and the resources and research needed to properly address the impact of Long-COVID POTS.

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Acute hyperhidrosis and postural tachycardia in a COVID-19 patient

Cited by 59 publications

References 5 publications

A Case of Postural Orthostatic Tachycardia Syndrome Secondary to the Messenger RNA COVID-19 Vaccine

A Case of Postural Orthostatic Tachycardia Syndrome Secondary to the Messenger RNA COVID-19 Vaccine

Autonomic dysfunction detection by an automatic pupillometer as a non-invasive test in patients recovered from COVID-19

Long-COVID postural tachycardia syndrome: an American Autonomic Society statement

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