Nikhil Prasad Fact checked by:Thailand Medical News Team Jul 26, 2024 1 month, 1 week, 5 days, 22 hours, 42 minutes ago
Medical News: Long COVID has become a major concern as many people continue to experience symptoms long after recovering from the initial infection. One of the troubling conditions associated with long COVID is orthostatic intolerance (OI), a disorder that affects the autonomic nervous system. This
Medical News report explores the findings of a study conducted by researchers from Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences-Japan, which sheds light on the clinical and endocrine features of OI in patients with long COVID.
New insights into orthostatic intolerance in long COVID patients
Image Credit: Krakenimages.com / Shutterstock
What is Orthostatic Intolerance?
Orthostatic intolerance refers to the body's inability to regulate blood pressure and heart rate upon standing. This can result in symptoms such as dizziness, nausea, and palpitations. In this study, researchers focused on understanding how OI manifests in patients suffering from long COVID.
Study Overview:
The study included 688 long COVID patients who visited the Okayama University clinic between February 2021 and April 2023. Among these, 86 patients suspected of having OI underwent an active standing test (ST). This article aims to highlight the key findings from this research.
Key Findings:
-Prevalence and Symptoms: Out of the 86 patients who underwent the ST, 33 (38%) tested positive for OI. These ST-positive patients often experienced nausea and tachycardia in their daily lives. The study found that during the active standing test, the increase in heart rate (HR) was significantly higher in the ST-positive group compared to the ST-negative group. Specifically, the HR increased by 30 beats per minute (bpm) in the ST-positive group, compared to 16 bpm in the ST-negative group.
-Age and Gender Differences: Interestingly, the median age of ST-positive patients was 20 years, significantly younger than the median age of 40 years in the ST-negative group. Additionally, nearly half (48.5%) of the ST-positive patients were under 20 years old, compared to only 20.8% in the ST-negative group. Gender ratios were similar in both groups, with no significant difference between male and female patients.
-Blood Pressure Changes: The study observed a greater initial increase in diastolic blood pressure (DBP) just after standing in the ST-positive group (+14 mmHg) compared to the ST-negative group (+9 mmHg). This acute rise in DBP, coupled with the HR increase, suggests a distinct pattern in patients with OI related to long COVID.
-Endocrine Abnormalities: The researchers also identified significant differences in hormone levels between the two groups. Serum cortisol levels were higher in ST-positive patients aged over 20, while growth hormone (G
H) levels were lower in ST-positive patients under 20. These findings indicate that endocrine dysfunctions may play a role in the development of OI in long COVID patients.
Autonomic Nervous System Dysfunction
The study reinforces the notion that autonomic nervous system dysfunction is a key factor in OI among long COVID patients. Symptoms like dizziness, shortness of breath, and general fatigue are common, and the acute rise in DBP just after standing is characteristic of ST-positive patients.
Endocrine System's Role
The researchers highlighted the potential impact of hormonal imbalances on OI. Increased serum cortisol levels in adults and decreased GH levels in younger patients suggest that the endocrine system's response to stress may be altered in long COVID patients. This could contribute to the overall symptomatology and severity of OI.
Clinical Implications and Recommendations for Clinicians
These findings are crucial for clinicians managing long COVID patients. Recognizing symptoms such as nausea and tachycardia, along with monitoring heart rate and blood pressure changes during the active standing test, can help identify OI. Furthermore, understanding the endocrine abnormalities associated with OI can lead to more effective treatments.
Clinicians should consider both autonomic and endocrine evaluations in long COVID patients presenting with symptoms of OI. Early detection through the active standing test and targeted hormonal assessments can aid in the development of personalized treatment plans. Addressing these underlying issues can improve patient outcomes and quality of life.
Conclusion:
The study from Okayama University highlights the prevalence and characteristics of orthostatic intolerance in long COVID patients. The findings emphasize the importance of considering both autonomic and endocrine factors in the diagnosis and management of OI. As research continues, it is crucial to develop comprehensive treatment strategies to address the complex needs of long COVID patients.
The study findings were published in the peer-reviewed journal: Scientific Reports.
https://link.springer.com/article/10.1038/s41598-024-67815-y
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Read Also:
https://www.thailandmedical.news/news/postural-orthostatic-tachycardia-syndrome-pots-linked-to-sexual-dysfunction
https://www.thailandmedical.news/news/long-covid-news-postural-orthostatic-tachycardia-syndrome-pots-and-dysautonomia-are-common-occurrences-in-long-covid
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