PDF(Pubmed)
Abstract：
Dysautonomia, or dysfunction of the autonomic nervous system (ANS), may occur following an infectious insult and can result in a variety of debilitating, widespread, and often poorly recognized symptoms. Dysautonomia is now widely accepted as a complication of COVID-19 and is an important component of Post-Acute Sequelae of COVID-19 (PASC or long COVID). PASC shares many overlapping clinical features with other infection-associated chronic illnesses including Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Post-Treatment Lyme Disease Syndrome (PTLDS), suggesting that they may share common underlying mechanisms including autonomic dysfunction. Despite the recognition of this complication of Lyme disease in the care of patients with PTLD, there has been a scarcity of research in this field and dysautonomia has not yet been established as a complication of Lyme disease in the medical literature. In this review, we discuss the evidence implicating Borrelia burgdorferi as a cause of dysautonomia and the related symptoms, propose potential pathogenic mechanisms given our knowledge of Lyme disease and mechanisms of PASC and ME/CFS, and discuss the diagnostic evaluation and treatments of dysautonomia. We also outline gaps in the literature and priorities for future research.
摘要：
自主神经失调,或自主神经系统（ANS）功能障碍，可能会在感染后发生，并可能导致各种衰弱，广泛，和经常识别不好的症状。自主神经失调现在被广泛认为是COVID-19的并发症，是COVID-19急性后后遗症(PASC或长COVID)的重要组成部分。PASC与其他感染相关的慢性疾病有许多重叠的临床特征，包括肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）和治疗后莱姆病综合征（PTLDS）。这表明它们可能具有共同的潜在机制，包括自主神经功能障碍。尽管在PTLD患者的护理中认识到莱姆病的这种并发症，该领域的研究很少，在医学文献中，自主神经障碍尚未被确定为莱姆病的并发症。在这次审查中,我们讨论了伯氏疏螺旋体作为自主神经失调的原因和相关症状的证据，鉴于我们对莱姆病的了解以及PASC和ME/CFS的机制，提出潜在的致病机制，并讨论了自主神经障碍的诊断评估和治疗。我们还概述了文献中的差距和未来研究的重点。
