Dataset Information

Dysautonomia following COVID-19 is not associated with subjective limitations or symptoms but is associated with objective functional limitations.

ABSTRACT:

Background

Individuals who contract coronavirus disease 2019 (COVID-19) can suffer with persistent and debilitating symptoms long after the initial acute illness. Heart rate (HR) profiles determined during cardiopulmonary exercise testing (CPET) and delivered as part of a post-COVID recovery service may provide insight into the presence and impact of dysautonomia on functional ability.

Objective

Using an active, working-age, post-COVID-19 population, the purpose of this study was to (1) determine and characterize any association between subjective symptoms and dysautonomia; and (2) identify objective exercise capacity differences between patients classified "with" and those "without" dysautonomia.

Methods

Patients referred to a post-COVID-19 service underwent comprehensive clinical assessment, including self-reported symptoms, CPET, and secondary care investigations when indicated. Resting HR >75 bpm, HR increase with exercise <89 bpm, and HR recovery <25 bpm 1 minute after exercise were used to define dysautonomia. Anonymized data were analyzed and associations with symptoms, and CPET outcomes were determined.

Results

Fifty-one of the 205 patients (25%) reviewed as part of this service evaluation had dysautonomia. There were no associations between symptoms or perceived functional limitation and dysautonomia (P >.05). Patients with dysautonomia demonstrated objective functional limitations with significantly reduced work rate (219 ± 37 W vs 253 ± 52 W; P <.001) and peak oxygen consumption (V̇o₂: 30.6 ± 5.5 mL/kg/min vs 35.8 ± 7.6 mL/kg/min; P <.001); and a steeper (less efficient) V̇e/V̇co₂ slope (29.9 ± 4.9 vs 27.7 ± 4.7; P = .005).

Conclusion

Dysautonomia is associated with objective functional limitations but is not associated with subjective symptoms or limitation.

SUBMITTER: Ladlow P

PROVIDER: S-EPMC8656177 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BACKGROUND:In this study, we analyzed elderly people in Thailand to identify the validity of suggested cutoff points of physical measures, handgrip strength, usual walking speed, and a composite score of both measures to predict functional limitations. Moreover, we examined whether these physical performance measures are accurate indicators of the investigated health outcomes. METHODS:Using Receiver Operating Characteristics (ROC) analysis, we investigated a sample of 8272 respondents aged 60 to 79?years. All data were based on the 2009 National Health Examination Survey (NHES IV) of Thailand. RESULTS:For males aged 60 to 69?years, handgrip strength was used as an indicator of functional limitations. The cutoff point for disabilities in the activities of daily living (ADLs) was 29.5?kg, while in other limitations it ranged from 28.7 to 31.3?kg. In contrast, usual walking speed was able to indicate ADL disabilities at 0.7?m per second (m/s). As one might expect, the cutoff points for males aged 70 to 79?years were lower than for males in the 60 to 69 age group. For females, handgrip strength was able to indicate ADL disabilities at 16.5?kg for both the 60 to 69, and 70 to 79 age groups. Likewise, walking speed was indicative of ADL disabilities at 0.6?m/s for both age groups. Interestingly, the composite measure increases the ability to detect ADL disabilities in the younger group but not in the older group. The area under the curve (AUC) of cutoffs measuring the detection power of a diagnostic test was varied, ranging from 0.535 to 0.7386. CONCLUSIONS:The cutoff points of three measures varied according to sex and type of functional limitations. Our findings also showed that physical performance measures were useful for identifying people with an increased risk of functional limitations, particularly for ADL disabilities. However, although the AUC of the cutoffs of other functional limitations were relatively low, they should be considered with caution.