Cardiovascular Autonomic and Immune Mechanism of Post COVID-19 Tachycardia Syndrome
Vanderbilt University Medical Center
Summary
The term post-acute COVID-19 syndrome or Long COVID is a disabling syndrome that persists beyond the 3-month convalescence period after COVID-19 infections. This syndrome affects mostly women (\~80%), present with chronic tachycardia and Orthostatic intolerance symptoms without any identifiable cause. In addition, non-specific symptoms such as fatigue, headache, and "brain fog", commonly described in POTS patients are also present in this novel condition, recently named post-COVID-19 tachycardia syndrome, POTS variant. Reduced Vagal activity and unresolved inflammation is post-COVID-19 POTS is hypothesized as the cause of Long COVID
Description
Post-acute sequelae of COVID-19 infection or Long COVID is a growing concern, even in patients with mild initial illness. These patients develop numerous chronic debilitating symptoms including fatigue, chest pain, reduced exercise tolerance and tachycardia, with symptoms persisting weeks beyond the initial infection. Preliminary data shows that post-COVID-19 POTS patients have reduced parasympathetic (PNS) function. Given that the PNS protects against inflammation, it is hypothesize that post-COVID-19 POTS is caused by reduced PNS activity, which in turn, contributes to persistent inflammati…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * Prior RT-PCR-confirmed COVID-19 infection. * Post-COVID-19 POTS will be defined as the presence of orthostatic tachycardia (\>30 bpm) and chronic (\>3 months) pre-syncopal symptoms. Exclusion criteria: * Heart Disease: Myocardial Infarction, angina, heart failure * History of stroke, or transient ischemic attack * Undergone an invasive procedure for CVD (coronary artery bypass graft, angioplasty, valve replacement, pacemaker placement or other vascular surgeries) * Uncontrolled hypertension defined as persistent blood pressure \>140/90. * Post-menopausal women. * Diabe…
Interventions
- Diagnostic TestLevels of inflammatory cytokine ( IL-6) in post-COVID-19 POTS and controls
Inflammatory and immune profile of post-COVID-19 POTS patients. Reduced PNS activity (vagal tone) in relation to persistent inflammation.
- Diagnostic TestLevels of inflammatory cytokine ( IL-6) in controls
Inflammatory and immune profile of healthy controls. Controls are the subjects who recovered from COVID-19 infection with no sequelae.
- Diagnostic TestEffect on inflammation after chronic PNS stimulation
Inflammatory biomarkers after restoring PNS function in post-COVID-19 POTS patients, by chronic transcutaneous vagus nerve stimulation (tVNS) in post COVID-19 POTS patients
Location
- Vanderbilt University Medical CenterNashville, Tennessee