Exaggerated blood pressure elevation in response to orthostatic challenge, a post-acute sequelae of SARS-CoV-2 infection (PASC) after hospitalization,Autonomic Neuroscience

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Exaggerated blood pressure elevation in response to orthostatic challenge, a post-acute sequelae of SARS-CoV-2 infection (PASC) after hospitalization
Autonomic Neuroscience ( IF 3.2 ) Pub Date : 2023-04-21 , DOI: 10.1016/j.autneu.2023.103094
J Antonio González-Hermosillo G ₁ , Esteban Jorge Galarza ₂ , Onasis Vicente Fermín ₁ , José Manuel Núñez González ₁ , Lucia Mariel Félix Álvarez Tostado ₁ , Marco Antonio Estrada Lozano ₁ , Claudia Ruíz Rabasa ₁ , María Del Rocio Martínez Alvarado ₂

Affiliation

Objective

Post-acute sequelae of SARS-COV-2 (PASC) are emerging as a major health challenge. Orthostatic intolerance secondary to autonomic failure has been found in PASC patients. This study investigated the effect of COVID-19 after recovery on blood pressure (BP) during the orthostatic challenge.

Research design and methods

Thirty-one out of 45 patients hospitalized due to COVID-19-related pneumonia that developed PASC and did not have hypertension at discharge were studied. They underwent a head-up tilt test (HUTT) at 10.8 ± 1.9 months from discharge. All met the PASC clinical criteria, and an alternative diagnosis did not explain the symptoms. This population was compared with 32 historical asymptomatic healthy controls.

Results

Exaggerated orthostatic blood pressure response (EOPR)/orthostatic hypertension (OHT) was detected in 8 out of 23 (34.7 %) patients, representing a significantly increased prevalence (7.67-fold increase p = 0.009) compared to 2 out of 32 (6.4 %) asymptomatic healthy controls matched by age, who underwent HUTT and were not infected with SARS-CoV-2.

Conclusions

This prospective evaluation in patients with PASC revealed abnormal blood pressure rise during the orthostatic challenge, suggesting of autonomic dysfunction in a third of the studied subjects. Our findings support the hypothesis that EOPR/OHT may be a phenotype of neurogenic hypertension. Hypertension in PASC patients may adversely affect the cardiovascular burden in the world.

中文翻译：

因直立性挑战而导致血压过度升高，这是住院后 SARS-CoV-2 感染 (PASC) 的急性后遗症

客观的

SARS-COV-2 (PASC) 的急性后遗症正在成为一项重大的健康挑战。 PASC 患者中发现继发于自主神经衰竭的直立不耐受。本研究调查了恢复后 COVID-19 对直立挑战期间血压 (BP) 的影响。

研究设计和方法

研究人员对 45 名因 COVID-19 相关肺炎住院的患者中的 31 名进行了研究，这些患者出现 PASC 并且出院时没有高血压。他们在出院后 10.8 ± 1.9 个月时接受了平视倾斜测试 (HUTT)。所有患者均符合 PASC 临床标准，并且替代诊断无法解释这些症状。该人群与 32 名历史上无症状的健康对照者进行了比较。

结果

23 名患者中有 8 名 (34.7%) 检测到过度直立性血压反应 (EOPR)/直立性高血压 (OHT)，与 32 名患者中的 2 名 (6.4%) 相比，患病率显着增加 (7.67 倍增加p = 0.009) ）年龄匹配的无症状健康对照，他们接受了 HUTT 并且没有感染 SARS-CoV-2。