PDF(Pubmed)
Abstract：
Orthostatic intolerance (OI) is a key symptom of long COVID; however, the pathophysiology remains unknown. Among 688 long COVID patients who visited our clinic during the period from February 2021 to April 2023, 86 patients who were suspected of having OI and who underwent an active standing test (ST) were investigated to elucidate the clinical characteristics of OI in patients with long COVID. Of the 86 patients, 33 patients (38%) were ST-positive. Nausea and tachycardia in daily life were frequent complaints in the ST-positive group. The increase in heart rate (HR) during the ST was significantly greater during a 10-min period after standing in the ST-positive group (+ 30 bpm) than in the ST-negative group (+ 16 bpm). The initial increase in diastolic blood pressure (DBP) just after standing was significantly greater in the ST-positive group (+ 14 mmHg) than in the ST-negative group (+ 9 mmHg). Serum cortisol levels in the ST-positive patients aged over 20 years were higher and growth hormone levels in the patients under 20 years of age were lower than those in the ST-negative group. Autonomous nervous symptoms, transient DBP rise with increasing HR after standing, and endocrine dysfunctions are helpful for detecting OI related to long COVID.
摘要：
直立不耐受(OI)是长型COVID的关键症状；然而，病理生理学仍然未知。在2021年2月至2023年4月期间到我们诊所就诊的688例长型COVID患者中，对86例怀疑患有OI并接受主动站立测试（ST）的患者进行了调查，以阐明长型COVID患者OI的临床特征。86名患者中,33例患者（38％）为ST阳性。在ST阳性组中，日常生活中的恶心和心动过速是常见的主诉。ST阳性组（30bpm）站立后10分钟内ST期间心率（HR）的增加明显大于ST阴性组（16bpm）。ST阳性组（14mmHg）站立后舒张压（DBP）的初始升高显着大于ST阴性组（9mmHg）。20岁以上ST阳性患者的血清皮质醇水平高于ST阴性组，20岁以下患者的生长激素水平低于ST阴性组。自主神经症状，站立后瞬时DBP随HR增加而升高，内分泌功能障碍有助于检测与长发COVID相关的OI。
