Abstract Details

Title Evaluating Long-Term Autonomic Dysfunction and Functional Impacts of Long COVID: A Follow-Up Study

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P1 - Poster Session 1 (11:45 AM-12:45 PM)

Poster/Presentation
Number 7-004

Objective In this study, we aimed to better understand the duration and severity of autonomic dysfunction in adults with Long COVID (LC) and evaluate its impact on function and quality of life. We also sought to assess risk factors of moderate to severe autonomic dysfunction in LC as well as the risk of developing postural tachycardia syndrome (POTS).

Background Autonomic dysfunction is a common complication of LC, however, longitudinal prevalence and autonomic symptom burden in Long COVID patients is not well-established.

Design/Methods

We utilized a cohort of LC patients, initially recruited in 2020-2021 for a prior study on autonomic dysfunction. Participants completed an online battery of questionnaires, including the COMPASS-31 for autonomic symptom severity and the RAND-36 for quality of life assessment. Multivariable logistic regression identified predictors of moderate-to-severe autonomic dysfunction and risk factors for developing postural tachycardia syndrome (POTS).

Results

526 adults (median age 48.5 [41-56] years, 88.8% female) were included in the final analysis, with a median symptom duration of 36 [30-40] months. 71.9% of participants had a COMPASS-31 score ≥ 20, indicating moderate to severe autonomic dysfunction. Significant predictors of COMPASS-31 scores ≥ 20 included female sex and joint hypermobility. 33.4% reported a new POTS diagnosis following SARS-CoV-2 infection, with significant predictors being age (OR=0.97, p=0.001) and joint hypermobility (OR=1.99, p=0.001). 37.5% of LC patients had to quit their job or drop out of school due to their LC illness.

Conclusions Evidence of persistent autonomic dysfunction was seen in 71.9% of LC participants in our study up to 3.5 years after initial SARS-CoV-2 infection, suggesting that chronic autonomic dysfunction is common in LC, with POTS being the most common autonomic diagnosis reported. Moderate to severe autonomic dysfunction was significantly correlated with impaired function and capacity, highlighting the need to address autonomic dysfunction as a key component of Long COVID management.

Authors/Disclosures
Mitchell G. Miglis, MD, FAAN (Stanford University Medical Center) PRESENTER	Dr. Miglis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alight Health. Dr. Miglis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Guidepoint, LLC. Dr. Miglis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for 2nd MD. Dr. Miglis has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Jazz Pharmaceuticals. Dr. Miglis has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Van Cott and Talamante. The institution of Dr. Miglis has received research support from Dysautonomia International. The institution of Dr. Miglis has received research support from National Institute of Health. Dr. Miglis has received publishing royalties from a publication relating to health care.
Ella Eastin	An immediate family member of Miss Eastin has received personal compensation for serving as an employee of Laura's House.
Jannika Machnik (Stanford University School of Medicine)	Jannika Machnik has nothing to disclose.
Nicholas W. Larsen, MD (Stanford University Medical Center)	An immediate family member of Dr. Larsen has stock in Health Care Select SPDR. An immediate family member of Dr. Larsen has stock in Ishares Biotechnology. Dr. Larsen has stock in Amazon.
Lauren Stiles	Lauren Stiles has received personal compensation for serving as an employee of Dysautonomia International.
Jordan Seliger	Jordan Seliger has nothing to disclose.
Linda N. Geng, MD, PhD	The institution of Prof. Geng has received research support from Pfizer, Inc.. The institution of Prof. Geng has received research support from NIH. The institution of Prof. Geng has received research support from AHRQ.
Hector Bonilla, MD	Dr. Bonilla has nothing to disclose.
Phillip Yang (Stanford University)	No disclosure on file

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