Autonomic dysregulation in long-term patients suffering from Post-COVID-19 Syndrome assessed by heart rate variability
❗Elegant study with more Vagus nerve impairment
➡️"Our data demonstrate persistent heart rate variability (HRV) alterations in PCS(LongCovid) patients with long-term symptom duration, suggesting a sustained impairment of sympathovagal balance"
➡️"PCS patients showed signs of a sympathetic overstimulation and a diminished parasympathetic response comparable to patients with CAD.
➡️"In addition, the relation of these HRV anomalies to the severity of the acute COVID-19 infection supports their relevance.
Study: PCS patients’ mean age was 49.0 ± 11.3 years, 45.7% were women. The median time interval between the (first) acute COVID-19 infection and start of medical rehabilitation (i. e. time of examination) was 252 (IQR 166–310) days. During acute infection, 31% had been hospitalized (38% with need for ventilation), 69% had received ambulant care or acute care at home. 24 h Holter-ECG
SARS-CoV-2 reservoir in post-acute sequelae of COVID-19 (PASC)
Lets dig into 1 of the 8 mechanisms that could cause LongCovid in this excellent study illustrating the importance of possible vagus involvement:
“SARS-CoV-2 reservoir may alter vagus nerve signaling”
🧵1/n
“A SARS-CoV-2 reservoir could also contribute to nonspecific PASC symptoms including fatigue, trouble concentrating, muscle and joint pain, sleep dysfunction, anxiety, depression, loss of appetite and autonomic dysfunction. These symptoms overlap with the sickness response (called ‘sickness behavior’ in animal models) that reflects the subjective and behavioral component of innate immunity and is largely mediated by signaling of the vagus nerve” 2/n
“Tens of thousands of afferent vagus nerve branches innervate all major trunk organs with chemoreceptor terminals, which collectively act as a sensitive and diffuse neuroimmune sensory organ for the CNS. These branches can detect highly localized paracrine immune signaling such as cytokine activation even in the absence of a systemic circulating immune response, triggering glial activation and neuroinflammation on the brain side of the blood–brain barrier and the sickness response. The persistence of a SARS-CoV-2 reservoir in body sites densely innervated by the vagus nerve (for example, gut, lung and bronchial tubes)—or direct infection of the vagus nerve as has been shown in autopsy studies—might activate localized paracrine signaling, leading to ongoing sickness response symptoms in infected individuals” 3/n
Why so little attention in #Belgium(=new red zone) for our well performing neighbor, Germany(Green zone)? They certainly seem to have their act together, surely they could be instrumental to learn from! #Thread#covid19 1/n @alexanderdecroo@JanJambon@eliodirupo
Testen:
FREE testing everywhere, with results in 15 minutes , to be stopped Oct 11, to further push unvaccinated to get their shot.
Mandatory tests in schools(2-3x/w) and all employers have to provide them for the employees at work. 2/n
3G rule:
For many places only admittance for vaccinated/post-covid starting 23 Aug
Only to be suspended when incidence reaches a 7D stable below 35! 3/n