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Dysautonomia in Children with Post-Acute Sequelae of Coronavirus 2019 Disease and/or Vaccination

Long-term health problems such as fatigue, palpitations, syncope, and dizziness are well-known in patients after COVID-19 (post-acute sequelae of coronavirus (PASC)). More recently, comparable problems have been noticed after the SARS-CoV-2 vaccination (post-VAC). The pathophysiology of these proble...

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Autor principal: Buchhorn, Reiner
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9607162/
https://www.ncbi.nlm.nih.gov/pubmed/36298551
http://dx.doi.org/10.3390/vaccines10101686
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author Buchhorn, Reiner
author_facet Buchhorn, Reiner
author_sort Buchhorn, Reiner
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description Long-term health problems such as fatigue, palpitations, syncope, and dizziness are well-known in patients after COVID-19 (post-acute sequelae of coronavirus (PASC)). More recently, comparable problems have been noticed after the SARS-CoV-2 vaccination (post-VAC). The pathophysiology of these problems is not well-understood. Methods: In 38 children and young adults, we tested if these health problems were related to dysautonomia in an active standing test (Group 1: 19 patients after COVID-19; Group 2: 12 patients with a breakthrough infection despite a vaccination; and Group 3: 7 patients after a vaccination without COVID-19). The data were compared with a control group of 47 healthy age-matched patients, as recently published. Results: All patients had a normal left ventricular function as measured by echocardiography. Significantly elevated diastolic blood pressure in all patient groups indicated a regulatory cardiovascular problem. Compared with the healthy control group, the patient groups showed significantly elevated heart rates whilst lying and standing, with significantly higher heart rate increases. The stress index was significantly enhanced in all patient groups whilst lying and standing. Significantly decreased pNN20 values, mostly whilst standing, indicated a lower vagus activity in all patient groups. The respiratory rates were significantly elevated in Groups 1 and 2. Conclusion: The uniform increase in the heart rates and stress indices, together with low pNN20 values, indicated dysautonomia in children with health problems after COVID-19 disease and/or vaccination. A total of 8 patients fulfilled the criteria of postural orthostatic tachycardia syndrome and 9 patients of an inappropriate sinus tachycardia, who were successfully treated with omega-3 fatty acid supplementation and pharmacotherapy.
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spelling pubmed-96071622022-10-28 Dysautonomia in Children with Post-Acute Sequelae of Coronavirus 2019 Disease and/or Vaccination Buchhorn, Reiner Vaccines (Basel) Brief Report Long-term health problems such as fatigue, palpitations, syncope, and dizziness are well-known in patients after COVID-19 (post-acute sequelae of coronavirus (PASC)). More recently, comparable problems have been noticed after the SARS-CoV-2 vaccination (post-VAC). The pathophysiology of these problems is not well-understood. Methods: In 38 children and young adults, we tested if these health problems were related to dysautonomia in an active standing test (Group 1: 19 patients after COVID-19; Group 2: 12 patients with a breakthrough infection despite a vaccination; and Group 3: 7 patients after a vaccination without COVID-19). The data were compared with a control group of 47 healthy age-matched patients, as recently published. Results: All patients had a normal left ventricular function as measured by echocardiography. Significantly elevated diastolic blood pressure in all patient groups indicated a regulatory cardiovascular problem. Compared with the healthy control group, the patient groups showed significantly elevated heart rates whilst lying and standing, with significantly higher heart rate increases. The stress index was significantly enhanced in all patient groups whilst lying and standing. Significantly decreased pNN20 values, mostly whilst standing, indicated a lower vagus activity in all patient groups. The respiratory rates were significantly elevated in Groups 1 and 2. Conclusion: The uniform increase in the heart rates and stress indices, together with low pNN20 values, indicated dysautonomia in children with health problems after COVID-19 disease and/or vaccination. A total of 8 patients fulfilled the criteria of postural orthostatic tachycardia syndrome and 9 patients of an inappropriate sinus tachycardia, who were successfully treated with omega-3 fatty acid supplementation and pharmacotherapy. MDPI 2022-10-09 /pmc/articles/PMC9607162/ /pubmed/36298551 http://dx.doi.org/10.3390/vaccines10101686 Text en © 2022 by the author. 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 Brief Report
Buchhorn, Reiner
Dysautonomia in Children with Post-Acute Sequelae of Coronavirus 2019 Disease and/or Vaccination
title Dysautonomia in Children with Post-Acute Sequelae of Coronavirus 2019 Disease and/or Vaccination
title_full Dysautonomia in Children with Post-Acute Sequelae of Coronavirus 2019 Disease and/or Vaccination
title_fullStr Dysautonomia in Children with Post-Acute Sequelae of Coronavirus 2019 Disease and/or Vaccination
title_full_unstemmed Dysautonomia in Children with Post-Acute Sequelae of Coronavirus 2019 Disease and/or Vaccination
title_short Dysautonomia in Children with Post-Acute Sequelae of Coronavirus 2019 Disease and/or Vaccination
title_sort dysautonomia in children with post-acute sequelae of coronavirus 2019 disease and/or vaccination
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9607162/
https://www.ncbi.nlm.nih.gov/pubmed/36298551
http://dx.doi.org/10.3390/vaccines10101686
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