COVID‐19 is getting on our nerves: sympathetic neural activity and haemodynamics in young adults recovering from SARS‐CoV‐2

Abstract

 The impact of SARS-CoV-2 infection on autonomic and cardiovascular function in otherwise healthy individuals is unknown. We show for the first time that young adults recovering from SARS-CoV-2 have elevated resting sympathetic activity, but similar heart rate and blood pressure, compared with control subjects. Survivors of SARS-CoV-2 also exhibit suppressed sympathetic nerve activity and pain perception during a cold pressor test compared with healthy controls.  Further, these individuals display higher sympathetic nerve activity throughout an orthostatic challenge, as well as an exaggerated heart rate response to orthostasis. If similar autonomic dysregulation, like that found here in young individuals, is present in older adults following SARS-CoV-2 infection, there may be substantial adverse implications for cardiovascular health.

Role of Body Mass and Physical Activity in Autonomic Function Modulation on Post-COVID-19 Condition: An Observational Subanalysis of Fit-COVID Study

“…Corroborating our findings, a recent study by Stute et al [5] also showed that young adults recovering from COVID-19 presented with autonomic dysregulation. The study used an invasive method (muscle sympathetic nerve activity) in 16 subjects after COVID-19 infection, which contrasts with our study that showed similar results through HRV analysis, a simple, dependable, inexpensive, and noninvasive method [32].…”

“…These findings may be attributed to the increased state of inflammation generated during COVID-19 infection, as well as the direct infusion of inflammatory cytokines [8,9]. These mechanisms are often characterized by marked increases in SNS activity [5,45]. The presence of markers of oxidative stress in COVID-19 and other viral diseases has been observed [8,46].…”

“…Initial studies showed that the harmful effects of COVID-19 could also reach the autonomic nervous system (ANS), even in non-hospitalized young individuals. Interestingly, detection of SARS-CoV-2 in carotid body of severe COVID-19 patients was previously reported, and its involvement may explain silent hypoxemia, a route of nervous system invasion and ANS deregulation [5][6][7]. It is hypothesized that autonomic dysfunction after COVID-19 infection could be mediated by the virus itself [8], or even associated with the cytokine storm response, resulting in oxidative stress.…”

Nitric oxide-mediated cutaneous microvascular function is not altered in young adults following mild-to-moderate SARS CoV-2 infection

“…During the screening visit, vaccinated and post-COVID-19 participants completed a COVID-19 symptoms severity survey, which lists the top 18 most common symptoms to COVID-19 ( 14 , 23 ). Participants rated each symptom on a scale of 0–100 of increasing severity.…”

Stellate ganglion block reduces symptoms of Long COVID: A case series

“…Symptoms can include fatigue, orthostatic intolerance, elevated resting heart rate, shortness of breath, brain fog, sleep disturbance, fevers, gastrointestinal symptoms, anosmia, dysgeusia, anxiety, and depression according to the World Health Organization clinical case definition ( Soriano et al, 2021 ). Dysautonomia, specifically excessive sympathetic nervous system activity, has been implicated in comorbidities of severe COVID-19 ( Porzionato et al, 2020 ), short-term recovery from acute COVID-19 ( Stute et al, 2021 ), and Long COVID ( Barizien et al, 2021 ; Dani et al, 2021 ).…”