We read with great interest the Review by Fedorowski et al. (A. Fedorowski et al. Cardiovascular autonomic dysfunction in post-COVID-19 syndrome: a major health-care burden. Nat. Rev. Cardiol. https://doi.org/10.1038/s41569-023-00962-3 (2024))¹. The authors provide a timely overview of the aetiology and clinical management of cardiovascular autonomic dysfunction (CVAD) in patients with long COVID (also known as post-COVID-19 syndrome). As clinicians involved in the care of, and research into, patients with long COVID, we endorse the statement that the recognition of CVAD is essential to the adequate management of long COVID. However, we cannot agree with the recommendations for graded exercise therapy for people living with long COVID who have post-exertional malaise.

我们饶有兴趣地阅读了 Fedorowski 等人的评论。 （A. Fedorowski 等人。COVID-19 后综合征中的心血管自主神经功能障碍：主要的医疗保健负担。Nat . Rev. Cardiol 。 https://doi.org/10.1038/s41569-023-00962-3 (2024 )) ¹ 。作者及时概述了长期 COVID（也称为 COVID-19 后综合征）患者心血管自主神经功能障碍 (CVAD) 的病因学和临床治疗。作为参与长期新冠肺炎患者护理和研究的临床医生，我们赞同这样的说法：承认 CVAD 对于长期新冠肺炎的充分管理至关重要。然而，我们不同意对患有长期新冠肺炎且出现运动后不适的人进行分级运动治疗的建议。