Many people continue to experience various physical and mental health effects after having COVID-19. This is known as long COVID. Some of these effects, such as dysautonomia, may be severe and affect heart rate and blood pressure.
Clinical studies indicate a possible link between COVID-19 and problems with the autonomic nervous system (ANS), also known as dysautonomia.
An estimated
This article will discuss the connection between dysautonomia and COVID-19 and tips for managing dysautonomia symptoms.
All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our coronavirus hub for the most recent information on COVID-19.
Dysautonomia is an umbrella term for disorders of the ANS. These disorders cause symptoms ranging from mild to severe. Although there is currently no cure, there are ways to manage symptoms.
There are two common dysautonomia conditions: postural orthostatic tachycardia syndrome (POTS) and postural hypotension.
Link with COVID-19
A high percentage of people with long COVID have symptoms of autonomic dysfunction. It
A 2022 global survey of over 2,000 adults suggests that even mild cases of COVID-19 can lead to significant autonomic dysfunction.
An estimated
What is the ANS?
The ANS controls various bodily functions, such as heart rate, blood pressure, and digestion. It also plays a role in regulating immune function. It keeps the body’s systems balanced at rest and in response to stress.
It has two branches: the sympathetic branch, which controls the “fight or flight” response, and the parasympathetic, which controls the “rest and digest” response.
These two branches are generally in balance. However, with dysautonomia, the responses are unbalanced, with the fight or flight response in overdrive. This causes a range of symptoms, from fatigue to a rapid heartbeat.
It is unclear exactly how COVID-19 causes dysautonomia. Researchers are uncertain whether it is a direct result of the SARS-CoV-2 virus on the ANS or a post-infection immune response.
However, possible mechanisms may include:
- Entry of the SARS-CoV-2 virus into the brain stem: This may affect the autonomic nervous centers that regulate breathing and other heart functions.
- Persistent inflammation and hypoxia, or low oxygen levels: This may lead to overactivation of the sympathetic nervous system.
- SARS-CoV-2 binding to receptors in endothelial cells: When the virus binds to receptors in endothelial cells that line arteries and veins in the autonomic system, inflammation may occur.
Postural hypotension
Postural hypotension involves a fall in blood pressure of more than 20 mm Hg systolic or more than 10 mm Hg diastolic, or both, when a person stands or sits upright from a lying position.
Symptoms can occur within a few seconds to a few minutes of standing and may include:
Postural orthostatic tachycardia syndrome
Postural orthostatic tachycardia syndrome (POTS) is a blood circulation disorder. In people with POTS, a very low volume of blood returns to the heart after standing up from a lying position, causing lightheadedness and fainting.
It also causes a rapid heartbeat within 10 minutes of standing that is relieved by lying down again. A rapid heartbeat is when the rate is greater than 120 beats per minute.
Additional symptoms can include:
POTS is one of the most common syndromes among people with long COVID and dysautonomia, with a
Dysautonomia symptoms can be unpredictable.
They can range from mild to severe, be intermittent or constant, and vary from person to person. This can make dysautonomia challenging to diagnose and manage.
Symptoms can include:
- brain fog
- fatigue
- dizziness
- fainting
- sweating
- difficulty breathing
- nausea and vomiting
- an abnormal heart rate
- heart palpitations
- visual problems and blurred vision
There is no cure for long COVID dysautonomia. However, there are ways to manage symptoms.
People with long COVID symptoms may find it helpful to speak with healthcare professionals to learn more about dysautonomia. A better understanding of their condition may make it easier for people to manage symptoms.
It is best for people to speak with a doctor before trying new treatments or changing their current treatment plan.
Breathing and relaxation techniques
When symptoms occur, people may find it helpful to employ techniques such as:
- using relaxation apps
- doing chair yoga
- meditating
- performing deep breathing exercises
Managing fatigue
Because dysautonomia can cause fatigue, it may be helpful to do the following:
- schedule the day to accommodate symptom flare-ups
- keep a regular sleep schedule
- avoid overextending or doing too much in one day
- pace activities slowly over time
Diet changes
Making adjustments to diet may also help with symptom management. These may include:
- eating several smaller meals instead of two or three large meals
- increasing fluids by drinking at least 2 liters of water daily
- increasing salt intake to 3–5 grams per day
- avoiding alcohol
Asking for help from others
Dealing with a new diagnosis of dysautonomia may feel overwhelming. Reaching out to others for support may help. Joining support groups may allow people to meet others with similar experiences.
Other self-care tips
Potential tips for managing symptoms include:
- elevating the head of the bed when sleeping
- maintaining an even temperature
- using compression garments, such as support hose and abdominal binders
- doing reclined aerobic exercise, such as swimming, rowing, and recumbent biking
The following are answers to some questions people commonly ask about COVID-19 and dysautonomia.
Is post-COVID POTS an autoimmune disease?
Researchers speculate that there is an autoimmune connection to post-COVID POTS. The fact that many people develop POTS after having infections, especially viral infections, indicates that the cause is autoimmune.
This syndrome also frequently occurs in people with autoimmune disorders, such as multiple sclerosis (MS) and celiac disease. Further studies have found the presence of various antibodies in people with POTS, leading to the conclusion that autoimmunity may play a significant role in post-COVID POTS.
Will dysautonomia go away?
Whether dysautonomia goes away depends on a person’s underlying health and treatment. Symptoms can be unpredictable and worsen due to stress, illness, or overexertion.
A 2021 study found that symptoms persisted in
However, other research from 2019 indicated that about
Researchers do not have a clear understanding of COVID-19’s role in dysautonomia.
However, evidence suggests the SARS-CoV-2 virus may cause significant changes to the ANS, potentially leading to a wide range of debilitating symptoms.
Although there is no specific cure for this condition, people may be able to manage symptoms with various self-care measures and medical treatments.