Autonomic neuropathy as post-acute sequela of SARS-CoV-2 infection: a case report

Shruti P Agnihotri; Carmela V San Luis; Mohamed Kazamel

doi:10.1007/s13365-022-01056-5

Autonomic neuropathy as post-acute sequela of SARS-CoV-2 infection: a case report

J Neurovirol. 2022 Feb;28(1):158-161. doi: 10.1007/s13365-022-01056-5. Epub 2022 Feb 18.

Authors

Shruti P Agnihotri¹, Carmela V San Luis¹, Mohamed Kazamel²

Affiliations

¹ Department of Neurology, University of Alabama at Birmingham, 1720 2nd Ave. South, SC271, Birmingham, AL, 35294-0017, USA.
² Department of Neurology, University of Alabama at Birmingham, 1720 2nd Ave. South, SC271, Birmingham, AL, 35294-0017, USA. mkazamel@uabmc.edu.

Abstract

Symptoms of autonomic dysfunction, particularly those of orthostatic intolerance, continue to represent a major component of the currently recognized post-acute sequelae of SARS-CoV-2 infections. Different pathophysiologic mechanisms can be involved in the development of orthostatic intolerance including hypovolemia due to gastrointestinal dysfunction, fatigue-associated deconditioning, and hyperadrenergic state due to pandemic-related anxiety. Additionally, there has been a well-established association of a common primary autonomic disorder like postural orthostatic tachycardia syndrome, a subtype of orthostatic intolerance, with antecedent viral infections. Here we report a case of neuropathic type postural orthostatic tachycardia syndrome as a form of autonomic neuropathy that developed following COVID-19 infection.

Keywords: Autonomic neuropathy; COVID-19; Orthostatic intolerance; Postural orthostatic tachycardia syndrome; Small fiber neuropathy; Valsalva maneuver.

Publication types

Case Reports

MeSH terms

COVID-19* / complications
Disease Progression
Fatigue / complications
Humans
Orthostatic Intolerance* / complications
Orthostatic Intolerance* / diagnosis
Postural Orthostatic Tachycardia Syndrome* / complications
Postural Orthostatic Tachycardia Syndrome* / diagnosis
SARS-CoV-2