Post-COVID-19 Tachycardia Syndrome: A Distinct Phenotype of Post-Acute COVID-19 Syndrome

Ståhlberg, Marcus; Reistam, Ulrika; Fedorowski, Artur; Villacorta, Humberto; Horiuchi, Yu; Bax, Jeroen J.; Pitt, Bertram; Matskeplishvili, Simon; Lüscher, Thomas F.; Weichert, Immo; Thani, Khalid Bin; Maisel, Alan S.

doi:10.1016/j.amjmed.2021.07.004

Cited by 134 publications

(131 citation statements)

References 28 publications

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“…It should be emphasized that POTS is a rare medical condition, and the onset of tachycardia following SARS-CoV-2 or any other viral infection can be more frequently explained as a physiological response of a perfectly intact autonomic nervous system. It has been recently suggested that post-COVID-19 tachycardia syndrome would represent a distinct disease entity, different from classical POTS [48].…”

Section: Covid-19 Infection and Dysautonomiamentioning

confidence: 99%

Post-Acute Sequelae of COVID-19 and Cardiovascular Autonomic Dysfunction: What Do We Know?

Bisaccia

Ricci

Recce

et al. 2021

JCDD

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Post-acute sequelae of SARS-CoV-2 (PASC), or long COVID syndrome, is emerging as a major health issue in patients with previous SARS-CoV-2 infection. Symptoms commonly experienced by patients include fatigue, palpitations, chest pain, dyspnea, reduced exercise tolerance, and “brain fog”. Additionally, symptoms of orthostatic intolerance and syncope suggest the involvement of the autonomic nervous system. Signs of cardiovascular autonomic dysfunction appear to be common in PASC and are similar to those observed in postural orthostatic tachycardia syndrome and inappropriate sinus tachycardia. In this review, we report on the epidemiology of PASC, discuss current evidence and possible mechanisms underpinning the dysregulation of the autonomic nervous system, and suggest nonpharmacological and pharmacological interventions to treat and relieve symptoms of PASC-associated dysautonomia.

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Section: Covid-19 Infection and Dysautonomiamentioning

confidence: 99%

Post-Acute Sequelae of COVID-19 and Cardiovascular Autonomic Dysfunction: What Do We Know?

Bisaccia

Ricci

Recce

et al. 2021

JCDD

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“…Many patients describe a postviral onset, [29][30][31][32] and 15%-20% of patients with POTS report a history of an autoimmune disorder such as Hashimoto thyroiditis, rheumatoid arthritis or Sjögren syndrome. 4 Recently, numerous cases of POTS 33 and other forms of sinus tachycardia (e.g., inappropriate sinus tachycardia) 34 after a SARS-CoV-2 infection have been reported. Good data on the frequency of POTS among patients with long-term complications from COVID-19 ("long COVID syndrome") are lacking.…”

Section: What Is the Pathophysiology Of Pots?mentioning

confidence: 99%

Diagnosis and management of postural orthostatic tachycardia syndrome

Raj

Fedorowski

Sheldon

2022

CMAJ

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Postural orthostatic tachycardia syndrome (POTS) is a chronic multisystem disorder; the cardinal feature is orthostatic tachycardia.• Patients with POTS have symptoms of orthostatic intolerance that improve with recumbence.• Girls and women are more commonly affected with POTS, beginning in puberty and through early adulthood.• Postural orthostatic tachycardia syndrome can lead to marked functional disability, often limiting work or schooling.• Treatments for POTS can improve symptoms and function, and can be initiated in primary care.

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“…Initial reports, currently confirmed, have highlighted the following residual effects of SARS-CoV-2 infection: fatigue, dyspnea, chest pain, cognitive impairment, arthralgia, and decline in quality of life (61). Symptomatic tachycardia, either presenting as postural orthostatic tachycardia syndrome or inappropriate sinus tachycardia, is also frequently reported in post-acute COVID-19 syndrome (62). All these symptoms may pose problems of differential diagnosis with symptoms originating from a primary cardiovascular problem.…”

Section: Post-acute Covid-19 Syndrome "(Long Covid)"mentioning

confidence: 99%

Cardio-Oncology in the COVID Era (Co & Co): The Never Ending Story

Bisceglia

Canale

Gallucci

et al. 2022

Front. Cardiovasc. Med.

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The pathophysiology of some non-communicable diseases (NCDs) such as hypertension, cardiovascular disease (CVD), diabetes, and cancer includes an alteration of the endothelial function. COVID-19 is a pulmonary and vascular disease with a negative impact on patients whose damaged endothelium is particularly vulnerable. The peculiar SARS-CoV-2-induced “endothelitis” triggers an intriguing immune-thrombosis that affects both the venous and arterial vascular beds. An increased liability for infection and an increased likelihood of a worse outcome have been observed during the pandemic in patients with active cancer and in cancer survivors. “Overlapping commonalities” between COVID-19 and Cardio-Oncology have been described that include shared phenotypes of cardiovascular toxicities such as left ventricular dysfunction, ischemic syndromes, conduction disturbances, myocarditis, pericarditis and right ventricular failure; shared pathophysiologic mechanisms such as inflammation, release of cytokines, the renin-angiotensin-aldosterone-pathway, coagulation abnormalities, microthrombosis and endothelial dysfunction. For these features and for the catalyst role of NCDs (mainly CVD and cancer), we should refer to COVID-19 as a “syndemic.” Another challenging issue is the persistence of the symptoms, the so-called “long COVID” whose pathogenesis is still uncertain: it may be due to persistent multi-organ viral attacks or to an abnormal immune response. An intensive vaccination campaign is the most successful pharmacological weapon against SARS-CoV-2, but the increasing number of variants has reduced the efficacy of the vaccines in controlling SARS-CoV-2 infections. After a year of vaccinations we have also learned more about efficacy and side-effects of COVID-19 vaccines. An important byproduct of the COVID-19 pandemic has been the rapid expansion of telemedicine platforms across different care settings; this new modality of monitoring cancer patients may be useful even in a post pandemic era. In this paper we analyze the problems that the cardio-oncologists are facing in a pandemic scenario modified by the extensive vaccination campaign and add actionable recommendations derived from the ongoing studies and from the syndemic nature of the infection.

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Post-COVID-19 Tachycardia Syndrome: A Distinct Phenotype of Post-Acute COVID-19 Syndrome

Cited by 134 publications

References 28 publications

Post-Acute Sequelae of COVID-19 and Cardiovascular Autonomic Dysfunction: What Do We Know?

Post-Acute Sequelae of COVID-19 and Cardiovascular Autonomic Dysfunction: What Do We Know?

Diagnosis and management of postural orthostatic tachycardia syndrome

Cardio-Oncology in the COVID Era (Co & Co): The Never Ending Story

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