PDF(Pubmed)
Abstract：
Background: Postural tachycardia syndrome (POTS) is a form of autonomic dysregulation. There is increasing evidence that the etiology may be immune-mediated in a subgroup of patients. Patients with POTS often experience an exacerbation of their symptoms associated with (viral) infections and often fear the same symptom aggravation after vaccination. In this report we describe the tolerability of messenger ribonucleic acid (mRNA) vaccines against coronavirus disease 19 (COVID-19) and the consequences of a COVID-19 infection on POTS symptoms in our cohort of patients with neuropathic POTS. Methods: We conducted a standardized, checklist-based interview with 23 patients and recorded the acute side effects of mRNA vaccination, acute symptoms of COVID-19 infection as well as the effects of vaccination and COVID-19 infection on POTS symptoms. Results: Of all included patients, 20 patients received two mRNA vaccines without having had a previous COVID-19 infection, and five patients in total had suffered a COVID-19 infection. Of these, three had COVID-19 without and two after being vaccinated. No increased frequency of side effects after both doses of mRNA vaccines was observed. Six patients reported a mild and short-term aggravation of their POTS symptoms beyond the duration of acute vaccine side effects. All five patients who suffered a COVID-19 infection subsequently reported a pronounced and persistent exacerbation of POTS symptoms. Conclusions: Our observations suggest that mRNA vaccines are not associated with a higher frequency of acute side effects in patients with POTS. Symptom exacerbation as a consequence of mRNA vaccination seems to be less frequent and of shorter duration compared to patients who suffered a COVID-19 infection.
摘要：
背景：体位性心动过速综合征（POTS）是自主神经失调的一种形式。越来越多的证据表明，在一组患者中，病因可能是免疫介导的。患有POTS的患者经常经历与（病毒）感染相关的症状恶化，并且经常担心接种疫苗后同样的症状恶化。在这份报告中，我们描述了针对冠状病毒病19（COVID-19）的信使核糖核酸（mRNA）疫苗的耐受性，以及COVID-19感染对我们的神经病性POTS患者队列中POTS症状的后果。方法：我们进行了标准化，对23例患者进行基于检查表的访谈，并记录mRNA疫苗接种的急性副作用，COVID-19感染的急性症状以及疫苗接种和COVID-19感染对POTS症状的影响。结果：在所有纳入的患者中，20例患者接受了两种mRNA疫苗，以前没有感染过COVID-19，共有5例患者感染了COVID-19。其中,3人没有接种COVID-19，2人接种疫苗后。在两种剂量的mRNA疫苗之后没有观察到副作用的频率增加。六名患者报告其POTS症状在急性疫苗副作用的持续时间内轻度和短期加重。所有五名感染COVID-19的患者随后报告POTS症状明显持续恶化。结论：我们的观察结果表明，mRNA疫苗与POTS患者的急性副作用频率升高无关。与COVID-19感染的患者相比，mRNA疫苗接种导致的症状恶化似乎频率较低，持续时间较短。
