Prevalence and patterns of symptoms of dysautonomia in patients with long-COVID syndrome: A cross-sectional study

Ahmed M Eldokla; Aliae A Mohamed-Hussein; Ahmed M Fouad; Mariam G Abdelnaser; Sara T Ali; Nahed A Makhlouf; Islam G Sayed; Hoda A Makhlouf; Jaffer Shah; Hani Aiash

doi:10.1002/acn3.51557

Prevalence and patterns of symptoms of dysautonomia in patients with long-COVID syndrome: A cross-sectional study

Ann Clin Transl Neurol. 2022 Jun;9(6):778-785. doi: 10.1002/acn3.51557. Epub 2022 Apr 8.

Authors

Ahmed M Eldokla^{1

2}, Aliae A Mohamed-Hussein³, Ahmed M Fouad⁴, Mariam G Abdelnaser⁵, Sara T Ali¹, Nahed A Makhlouf⁶, Islam G Sayed⁵, Hoda A Makhlouf³, Jaffer Shah⁷, Hani Aiash^{8

9}

Affiliations

¹ Department of Neurology, State University of New York, Upstate Medical University, Syracuse, New York, 13210, USA.
² Department of Pathology, State University of New York, Upstate Medical University, Syracuse, New York, 13210, USA.
³ Chest Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
⁴ Department of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
⁵ Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt.
⁶ Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut, Egypt.
⁷ New York State Department of Health, Albany, New York, USA.
⁸ Department of Family Medicine, Suez Canal University, Ismailia, Egypt.
⁹ Department of Cardiovascular Perfusion, State University of New York, Upstate Medical University, Syracuse, New York, 13210, USA.

Abstract

Background: The association between autonomic dysfunction and long-COVID syndrome is established. However, the prevalence and patterns of symptoms of dysautonomia in long-COVID syndrome in a large population are lacking.

Objective: To evaluate the prevalence and patterns of symptoms of dysautonomia in patients with long-COVID syndrome.

Methods: We administered the Composite Autonomic Symptom Score 31 (COMPASS-31) questionnaire to a sample of post-COVID-19 patients who were referred to post-COVID clinic in Assiut University Hospitals, Egypt for symptoms concerning for long-COVID syndrome. Participants were asked to complete the COMPASS-31 questionnaire referring to the period of more than 4 weeks after acute COVID-19.

Results: We included 320 patients (35.92 ± 11.92 years, 73% females). The median COMPASS-31 score was 26.29 (0-76.73). The most affected domains of dysautonomia were gastrointestinal, secretomotor, and orthostatic intolerance with 91.6%, 76.4%, and 73.6%, respectively. There was a positive correlation between COMPASS-31 score and long-COVID duration (p < 0.001) and a positive correlation between orthostatic intolerance domain score and post-COVID duration (p < 0.001). There was a positive correlation between orthostatic intolerance domain score and age of participants (p = 0.004). Two hundred forty-seven patients (76.7%) had a high score of COMPASS-31 >16.4. Patients with COMPASS-31 >16.4 had a longer duration of long-COVID syndrome than those with score <16.4 (46.2 vs. 26.8 weeks, p < 0.001).

Conclusions: Symptoms of dysautonomia are common in long-COVID syndrome. The most common COMPASS-31 affected domains of dysautonomia are gastrointestinal, secretomotor, and orthostatic intolerance. There is a positive correlation between orthostatic intolerance domain score and patients' age.

MeSH terms

COVID-19* / complications
COVID-19* / epidemiology
Cross-Sectional Studies
Female
Humans
Male
Orthostatic Intolerance*
Post-Acute COVID-19 Syndrome
Prevalence
Primary Dysautonomias* / epidemiology
Primary Dysautonomias* / etiology
Syndrome