PDF(Pubmed)
Abstract：
BACKGROUND: Post-Coronavirus disease 2019 (Post-COVID-19) syndrome has neurological symptoms related to the dysfunction of the autonomous nerve system. However, a pathogenic relationship between post-COVID-19 syndrome and dysautonomia still remains to be demonstrated. Establishing a pathogenic relationship between paresthesia and the presence of cardiac dysautonomia in patients with post-COVID-19 syndrome is the objective of this study.
METHODS: This observational study was carried out in the neurophysiology service wing of the Juan Bruno Zayas Hospital, Santiago de Cuba, in Cuba. The patients were recruited through a post-COVID-19 clinic at the same hospital. A variability study of cardiac frequency and a test of autonomic cardiovascular reflexes was carried out, which is composed of deep breathing, orthostatism, and the Valsalva maneuver.
RESULTS: The variability parameters of the cardiac frequency, the expiration-inspiration ratio between deep breaths, and the Valsalva Index showed no statistically significant differences between healthy participants and those with post-COVID-19 syndrome. During the Valsalva maneuver, there was a greater cardiac frequency response in participants with post-COVID-19 syndrome than in healthy subjects. The difference in supine and standing blood pressure was significantly minor in patients with post-COVID-19 syndrome. The logarithm of high frequency (log HF) increased significantly in patients with paresthesia when compared to patients without paresthesia.
CONCLUSIONS: In the autonomic function tests, no signs of dysautonomia were found in patients with post-COVID-19 syndrome. The presence of paresthesias is associated with differences in cardiac vagal activity, which may suggest that damage to peripheral sensory nerve fibers could be associated with an affectation to autonomic fibres.
METHODS: This observational study was carried out in the neurophysiology service wing of the Juan Bruno Zayas Hospital, Santiago de Cuba, in Cuba. The patients were recruited through a post-COVID-19 clinic at the same hospital. A variability study of cardiac frequency and a test of autonomic cardiovascular reflexes was carried out, which is composed of deep breathing, orthostatism, and the Valsalva maneuver.
RESULTS: The variability parameters of the cardiac frequency, the expiration-inspiration ratio between deep breaths, and the Valsalva Index showed no statistically significant differences between healthy participants and those with post-COVID-19 syndrome. During the Valsalva maneuver, there was a greater cardiac frequency response in participants with post-COVID-19 syndrome than in healthy subjects. The difference in supine and standing blood pressure was significantly minor in patients with post-COVID-19 syndrome. The logarithm of high frequency (log HF) increased significantly in patients with paresthesia when compared to patients without paresthesia.
CONCLUSIONS: In the autonomic function tests, no signs of dysautonomia were found in patients with post-COVID-19 syndrome. The presence of paresthesias is associated with differences in cardiac vagal activity, which may suggest that damage to peripheral sensory nerve fibers could be associated with an affectation to autonomic fibres.
摘要：
背景：2019年冠状病毒病（后COVID-19）综合征具有与自主神经系统功能障碍相关的神经症状。然而,COVID-19后综合征与自主神经功能障碍之间的致病关系仍有待证实。在COVID-19后综合征患者中建立感觉异常与心脏自主神经障碍之间的致病关系是本研究的目的。
方法：这项观察性研究是在JuanBrunoZayas医院的神经生理学服务部门进行的，古巴圣地亚哥,在古巴。这些患者是通过同一家医院的COVID-19后诊所招募的。进行了心脏频率的变异性研究和自主性心血管反射的测试，由深呼吸组成，正交统计，还有Valsalva的动作.
结果：心脏频率的变异性参数，深呼吸之间的呼气-吸气比，Valsalva指数显示，健康参与者和COVID-19后综合征患者之间无统计学差异。在瓦尔萨尔瓦演习中,与健康受试者相比,患有COVID-19后综合征的参与者的心频反应更大.COVID-19后综合征患者仰卧和站立血压的差异明显较小。与没有感觉异常的患者相比，感觉异常的患者的高频对数（logHF）显着增加。
结论：在自主功能测试中，在COVID-19后综合征患者中未发现自主神经失调的迹象。感觉异常的存在与心脏迷走神经活动的差异有关，这可能表明对周围感觉神经纤维的损害可能与对自主神经纤维的影响有关。
方法：这项观察性研究是在JuanBrunoZayas医院的神经生理学服务部门进行的，古巴圣地亚哥,在古巴。这些患者是通过同一家医院的COVID-19后诊所招募的。进行了心脏频率的变异性研究和自主性心血管反射的测试，由深呼吸组成，正交统计，还有Valsalva的动作.
结果：心脏频率的变异性参数，深呼吸之间的呼气-吸气比，Valsalva指数显示，健康参与者和COVID-19后综合征患者之间无统计学差异。在瓦尔萨尔瓦演习中,与健康受试者相比,患有COVID-19后综合征的参与者的心频反应更大.COVID-19后综合征患者仰卧和站立血压的差异明显较小。与没有感觉异常的患者相比，感觉异常的患者的高频对数（logHF）显着增加。
结论：在自主功能测试中，在COVID-19后综合征患者中未发现自主神经失调的迹象。感觉异常的存在与心脏迷走神经活动的差异有关，这可能表明对周围感觉神经纤维的损害可能与对自主神经纤维的影响有关。
