Cargando…
Detecting Orthostatic Intolerance in Long COVID in a Clinic Setting
Introduction: A likely mechanism of Long COVID (LC) is dysautonomia, manifesting as orthostatic intolerance (OI). In our LC service, all patients underwent a National Aeronautics and Space Administration (NASA) Lean Test (NLT), which can detect OI syndromes of Postural Tachycardia Syndrome (PoTS) or...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10218406/ https://www.ncbi.nlm.nih.gov/pubmed/37239531 http://dx.doi.org/10.3390/ijerph20105804 |
_version_ | 1785048765854384128 |
---|---|
author | Isaac, Robert Oliver Corrado, Joanna Sivan, Manoj |
author_facet | Isaac, Robert Oliver Corrado, Joanna Sivan, Manoj |
author_sort | Isaac, Robert Oliver |
collection | PubMed |
description | Introduction: A likely mechanism of Long COVID (LC) is dysautonomia, manifesting as orthostatic intolerance (OI). In our LC service, all patients underwent a National Aeronautics and Space Administration (NASA) Lean Test (NLT), which can detect OI syndromes of Postural Tachycardia Syndrome (PoTS) or Orthostatic Hypotension (OH) in a clinic setting. Patients also completed the COVID-19 Yorkshire Rehabilitation Scale (C19-YRS), a validated LC outcome measure. Our objectives in this retrospective study were (1) to report on the findings of the NLT; and (2) to compare findings from the NLT with LC symptoms reported on the C19-YRS. Methods: NLT data, including maximum heart rate increase, blood pressure decrease, number of minutes completed and symptoms experienced during the NLT were extracted retrospectively, together with palpitation and dizziness scores from the C19-YRS. Mann-Witney U tests were used to examine for statistical difference in palpitation or dizziness scores between patients with normal NLT and those with abnormal NLT. Spearman’s rank was used to examine the correlation between the degree of postural HR and BP change with C19-YRS symptom severity score. Results: Of the 100 patients with LC recruited, 38 experienced symptoms of OI during the NLT; 13 met the haemodynamic screening criteria for PoTS and 9 for OH. On the C19-YRS, 81 reported dizziness as at least a mild problem, and 68 for palpitations being at least a mild problem. There was no significant statistical difference between reported dizziness or palpitation scores in those with normal NLT and those with abnormal NLT. The correlation between symptom severity score and NLT findings was <0.16 (poor). Conclusions: We have found evidence of OI, both symptomatically and haemodynamically in patients with LC. The severity of palpitations and dizziness reported on the C19-YRS does not appear to correlate with NLT findings. We would recommend using the NLT in all LC patients in a clinic setting, regardless of presenting LC symptoms, due to this inconsistency. |
format | Online Article Text |
id | pubmed-10218406 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-102184062023-05-27 Detecting Orthostatic Intolerance in Long COVID in a Clinic Setting Isaac, Robert Oliver Corrado, Joanna Sivan, Manoj Int J Environ Res Public Health Article Introduction: A likely mechanism of Long COVID (LC) is dysautonomia, manifesting as orthostatic intolerance (OI). In our LC service, all patients underwent a National Aeronautics and Space Administration (NASA) Lean Test (NLT), which can detect OI syndromes of Postural Tachycardia Syndrome (PoTS) or Orthostatic Hypotension (OH) in a clinic setting. Patients also completed the COVID-19 Yorkshire Rehabilitation Scale (C19-YRS), a validated LC outcome measure. Our objectives in this retrospective study were (1) to report on the findings of the NLT; and (2) to compare findings from the NLT with LC symptoms reported on the C19-YRS. Methods: NLT data, including maximum heart rate increase, blood pressure decrease, number of minutes completed and symptoms experienced during the NLT were extracted retrospectively, together with palpitation and dizziness scores from the C19-YRS. Mann-Witney U tests were used to examine for statistical difference in palpitation or dizziness scores between patients with normal NLT and those with abnormal NLT. Spearman’s rank was used to examine the correlation between the degree of postural HR and BP change with C19-YRS symptom severity score. Results: Of the 100 patients with LC recruited, 38 experienced symptoms of OI during the NLT; 13 met the haemodynamic screening criteria for PoTS and 9 for OH. On the C19-YRS, 81 reported dizziness as at least a mild problem, and 68 for palpitations being at least a mild problem. There was no significant statistical difference between reported dizziness or palpitation scores in those with normal NLT and those with abnormal NLT. The correlation between symptom severity score and NLT findings was <0.16 (poor). Conclusions: We have found evidence of OI, both symptomatically and haemodynamically in patients with LC. The severity of palpitations and dizziness reported on the C19-YRS does not appear to correlate with NLT findings. We would recommend using the NLT in all LC patients in a clinic setting, regardless of presenting LC symptoms, due to this inconsistency. MDPI 2023-05-12 /pmc/articles/PMC10218406/ /pubmed/37239531 http://dx.doi.org/10.3390/ijerph20105804 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Isaac, Robert Oliver Corrado, Joanna Sivan, Manoj Detecting Orthostatic Intolerance in Long COVID in a Clinic Setting |
title | Detecting Orthostatic Intolerance in Long COVID in a Clinic Setting |
title_full | Detecting Orthostatic Intolerance in Long COVID in a Clinic Setting |
title_fullStr | Detecting Orthostatic Intolerance in Long COVID in a Clinic Setting |
title_full_unstemmed | Detecting Orthostatic Intolerance in Long COVID in a Clinic Setting |
title_short | Detecting Orthostatic Intolerance in Long COVID in a Clinic Setting |
title_sort | detecting orthostatic intolerance in long covid in a clinic setting |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10218406/ https://www.ncbi.nlm.nih.gov/pubmed/37239531 http://dx.doi.org/10.3390/ijerph20105804 |
work_keys_str_mv | AT isaacrobertoliver detectingorthostaticintoleranceinlongcovidinaclinicsetting AT corradojoanna detectingorthostaticintoleranceinlongcovidinaclinicsetting AT sivanmanoj detectingorthostaticintoleranceinlongcovidinaclinicsetting |