背景:严重急性呼吸道综合征冠状病毒2(SARS-CoV-2;或COVID-19)引起的自主神经失调的出现越来越普遍。我们已经在一些COVID后患者和文献中看到了不同程度的自主神经功能障碍的证据。症状,其中,包括不适当的心动过速,出汗,焦虑,失眠和血压变异性来自过量的儿茶酚胺的影响,以及认知障碍,疲劳,大脑灌注减少引起的头痛和直立不耐受。
方法:我们介绍了一例先前健康的27岁跑步者的严重自主神经障碍。在她最初轻度感染COVID-19大约五周后,病人开始出现虚弱,进展为严重的劳累后疲劳,认知减慢,头痛,视力模糊和全身疼痛。她也赞同心悸,特别是当从坐着或躺着的位置以及轻微的劳累站起来时。她开始依赖丈夫来帮助她的日常生活活动。检查对矫正很重要;实验室检查不明显。在接下来的几个月里,患者的症状随着液体和钠的摄入而缓慢改善,压力袜和参加毕业的锻炼计划。
结论:由于COVID-19感染引起的自主神经紊乱越来越被讨论,特别是随着越来越多的患者从COVID-19中恢复过来。这是一例非住院患者,初始表现轻度且意义重大,使人衰弱的自主神经障碍症状。更多关于其病理生理学的研究,尤其是关于病毒攻击的先例,以及它的治疗,是需要的。
BACKGROUND: The emergence of dysautonomia as a consequence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; or COVID-19) is becoming more prevalent. We have seen evidence in several post-COVID patients and in the literature of varying degrees of autonomic dysfunction. Symptoms, among others, include inappropriate tachycardia, sweating, anxiety, insomnia and blood pressure variability from the effects of excessive catecholamine, as well as cognitive impairment, fatigue, headaches and orthostatic intolerance from decreased brain perfusion.
METHODS: We present a
case of severe dysautonomia in a previously healthy 27-year-old runner. About five weeks after her initial mild COVID-19 infection, the patient began to develop weakness, which progressed into severe post-exertional fatigue, slowed cognition, headaches, blurred vision and generalized body aches. She also endorsed palpitations, especially when getting up from a seated or lying position as well as with mild exertion. She became reliant on her husband for help with her activities of daily living. Exam was significant for orthostasis; laboratory workup unremarkable. Over the following months, the patient\'s symptoms have improved slowly with fluid and sodium intake, compression stockings and participating in a graduated exercise program.
CONCLUSIONS: Dysautonomia as a consequence of infection with COVID-19 is becoming increasingly discussed, especially as more patients recover from COVID-19. This is a
case of a non-hospitalized patient with a mild initial presentation and significant, debilitating dysautonomia symptoms. More research on its pathophysiology, especially in relation to a precedent viral insult, as well as its treatment, is needed.