Multi‐disciplinary collaborative consensus guidance statement on the assessment and treatment of autonomic dysfunction in patients with post‐acute sequelae of SARS‐CoV ‐2 infection ( PASC )

作者：Svetlana Blitshteyn, Jonathan Whiteson, Benjamin Abramoff, Alba Azola, Matthew N. Bartels, Ratna Bhavaraju‐Sanka, Tae Chung, Talya K. Fleming, Ellen Henning, Mitchell G. Miglis, Sarah Sampsel, Julie K. Silver, Jenna Tosto, Monica Verduzco‐Gutierrez, David Putrino · 发表于：PM&R · 年份：2022 · DOI：10.1002/pmrj.12894 · 被引用次数：79 · 研究领域：Long-Term Effects of COVID-19、Heart Rate Variability and Autonomic Control、Cardiovascular Syncope and Autonomic Disorders

Although many people infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) recover completely, others are left with long-lasting symptoms that persist for at least 4 weeks, a condition referred to by the National Institutes of Health (NIH) as post-acute sequelae of SARS-CoV-2 infection (PASC).1 The Centers for Disease Control and Prevention (CDC) defines post-COVID (coronavirus disease) conditions as the wide range of health consequences that are present for four or more weeks after infection with SARS-CoV-2,2 whereas the World Health Organization (WHO) refers to post-COVID condition as symptoms that persist beyond 12 weeks after an initial infection, last for at least 2 months, and cannot be explained by an alternative diagnosis.3 There are a number of terms found in the literature that describe this condition (e.g., long COVID, persisting symptoms post-COVID, post-acute COVID-19, long-haul COVID, and others), but for the purposes of this statement, the term PASC is used. PASC can present with a non-specific constellation of signs and symptoms,4 some of which appear to be autonomic in nature. These include, but are not limited to, orthostatic intolerance, palpitations, tachycardia, syncope, orthostatic hypertension, labile blood pressures, dizziness, fatigue, and exercise intolerance.5 The most common autonomic diagnoses associated with PASC are orthostatic intolerance and postural orthostatic tachycardia syndrome (POTS), which often follow a viral infec...