![]() We also selected a third control group of 20 gender- and age-matched healthy adults without ME/CFS. In light of the reported occurrence of POTS following COVID-19, we selected 20 ME/CFS controls with POTS and 20 without POTS. The ME/CFS controls became ill at least 2 years before the start of the SARS-CoV-2 pandemic. We noted if study participants were using medications that could alter heart rate (HR) or blood pressure (BP), and these drugs were discontinued before performing the tilt test. Moreover, we scored ME/CFS symptoms based on the Institute of Medicine (IOM) criteria. ![]() The diagnosis of ME/CFS was made according to the ME/CFS criteria of the International Consensus Criteria (ICC), and we excluded those with any other illnesses that could explain the symptomatology. For this study, we chose a conservative, elevated Beighton score of 6 or higher as the threshold for confirming the diagnosis of hypermobility. In the event of a positive answer, the Beighton score was obtained. In all other patients seen during the study period, in whom a formal diagnosis of hypermobility had not been established, we asked whether they were highly flexible or were hypermobile. Patients were considered hypermobile if the diagnosis of joint hypermobility, or hypermobile Ehlers-Danlos Syndrome (hEDS) had been made by a geneticist, rheumatologist, or specialized rehabilitation physician. It was not possible to match this variable by gender, given the small number of hypermobile males in our ME/CFS database. Because our previous research showed that patients with hypermobility have a larger cerebral blood flow reduction during head-up tilt, and with 3/10 of long-haul COVID-19 patients being diagnosed with hypermobility, we also ensured that 30 percent or the ME/CFS patients also met criteria for joint hypermobility. ME/CFS controls were matched to the long-COVID-19 cases first by gender, then by age (+/− 1 years), selecting the closest matching patient to the case. The controls were identified from the clinic database of ME/CFS patients who visited our clinic between November 2015 and July 2021, in whom a tilt test was performed for quantification of orthostatic intolerance (OI). These data suggest that similar to SARS-CoV-1, SARS-CoV-2 infection acts as a trigger for the development of ME/CFS. The finding of early-onset orthostatic intolerance symptoms, and the high pre-illness physical activity level of the long-haul COVID-19 patients, makes it unlikely that POTS in this group is due to deconditioning. Cerebral blood flow and cardiac index reductions during tilt were more severely impaired than in many patients with ME/CFS. Conclusions: The symptoms of long-haul COVID-19 are similar to those of ME/CFS patients, as is the response to tilt testing. The cerebral blood flow reduction was larger in the long-haul COVID-19 patients compared with the ME/CFS patients with a normal heart rate and blood pressure response. ![]() Cardiac index reduction was not different between the three patient groups. Cerebral blood flow and cardiac index were more significantly reduced in the three patient groups compared with the healthy controls. All long-haul COVID-19 patients developed POTS during tilt. Results: There were no significant differences in ME/CFS symptom prevalence between the long-haul COVID-19 patients and the ME/CFS patients. Identical symptom questionnaires and tilt test procedures were used for all groups, including measurement of cerebral blood flow and cardiac index during the orthostatic stress. Materials and Methods: We compared 10 consecutive long-haul COVID-19 cases with 20 age- and gender-matched ME/CFS controls with postural tachycardia syndrome (POTS) during head-up tilt, 20 age- and gender-matched ME/CFS controls with a normal heart rate and blood pressure response to head-up tilt, and 10 age- and gender-matched healthy controls. To investigate the overlap in these clinical phenotypes, we compared orthostatic symptoms in daily life and during head-up tilt, heart rate and blood pressure responses to tilt, and reductions in cerebral blood flow in response to orthostatic stress in long-haul COVID-19 patients, ME/CFS controls, and healthy controls. Background and Objectives: Symptoms and hemodynamic findings during orthostatic stress have been reported in both long-haul COVID-19 and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), but little work has directly compared patients from these two groups. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |