Cesar Acosta
Wyckoff Heights Medical Hospital, USATitle: COVID’s affect on the autonomic nervous system
Abstract
COVID-19 leads to a
multi-organ disorder due to the effects of (1) angiotensin converting
enzyme-2 receptors (the entry points for the virus), (2) inflammation and (3)
oxidative stress (the resultant effects of the virus). These effects
may produce a spectrum of respiratory and cardio-neuro effects (e.g.,
myocardial injury, primary arrhythmia, and cardiac symptoms due to autonomic
dysfunction) which may affect all systems of the body. We discuss the
symptoms and suggest therapies that target the underlying autonomic dysfunction
to relieve the symptoms, rather than merely treating symptoms. In
addition to treating the autonomic dysfunction, the therapy also treats chronic
inflammation and oxidative stress. If a full non-invasive cardiac work-up
is performed and is negative, a full assessment of the autonomic nervous
system, specifying Parasympathetic and Sympathetic activity, both at rest
and in response to challenges, is recommended. Cardiac symptoms of
dyspnea, chest pain, and palpitations need to be assessed objectively to
differentiate cardiac from neural (autonomic) etiology. Long-term
myocardial injury commonly involves Parasympathetic or
Sympathetic dysfunction. Parasympathetic and Sympathetic
assessment usually connects most symptoms of COVID-19 to the documented
autonomic dysfunction(s).
Biography
To be updated