Autonomic dysfunction in SARS-COV-2 infection acute and long-term implications COVID-19 editor’s page series

• Published in: Journal of thrombosis and thrombolysis Vol. 52; no. 3; pp. 692 - 707
• Main Author: Becker, Richard C.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.10.2021; Springer Nature B.V
• Subjects: Animals; Autonomic nervous system; Autonomic Nervous System - physiopathology; Autonomic Nervous System - virology; Autonomic Nervous System Diseases - diagnosis; Autonomic Nervous System Diseases - physiopathology; Autonomic Nervous System Diseases - virology; Blood pressure; Brain stem; Cardiac arrhythmia; Cardiology; Complications; Coronaviruses; COVID-19; COVID-19 - complications; COVID-19 - diagnosis; COVID-19 - physiopathology; COVID-19 - virology; Dysautonomia; Fatigue; Hematology; Host-Pathogen Interactions; Humans; Infections; Medicine; Medicine & Public Health; Nervous system; Outbreaks; Physiology; Prognosis; SARS-CoV-2 - pathogenicity; Severe acute respiratory syndrome coronavirus 2; Spinal cord; Tachycardia; Time Factors; COVID-19; Post-acute sequelae of SARS-CoV-2 infection (PASC); Dysautonomia
• ISSN: 0929-5305; 1573-742X
• DOI: 10.1007/s11239-021-02549-6

The autonomic nervous system (ANS) is a complex network of nerves originating in the brain, brain stem, spinal cord, heart and extracardiac organs that regulates neural and physiological responses to internal and external environments and conditions. A common observation among patients with the 2019 Coronavirus (CoV) (SARS-severe acute respiratory syndrome CoV-2) (SARS-CoV-2) or COVID-19 [ CO for corona, VI for virus, D for disease and 19 for when the outbreak was first identified (31 December 2019)] in the acute and chronic phases of the disease is tachycardia, labile blood pressure, muscular fatigue and shortness of breath. Because abnormalities in the ANS can contribute to each of these symptoms, herein a review of autonomic dysfunction in SARS-COV-2 infection is provided to guide diagnostic testing, patient care and research initiatives. Graphic abstract The autonomic nervous system is a complex network of nerves originating in the brain, brain stem, spinal cord, heart and extracardiac organs that regulates neural and physiological responses to internal and external environments and conditions. A common collection of signs and symptoms among patients with the 2019 Coronavirus (CoV) (SARS-severe acute respiratory syndrome CoV-2) (SARS-CoV-2) or COVID-19 [ CO for corona, VI for virus, D for disease and 19 for when the outbreak was first identified (31 December 2019)] is tachycardia, labile blood pressure, muscular fatigue and shortness of breath. Abnormalities in the autonomic nervous system (ANS) can contribute to each of these identifiers, potentially offering a unifying pathobiology for acute, subacute and the long-term sequelae of SARS-CoV-2 infection (PASC) and a target for intervention.