We describe clinical and laboratory findings in 35 consecutive patients tested positive for SARS-CoV-2 by reverse transcriptase-polymerase chain reaction on nasopharyngeal swab that presented one or multiple syncopal events at disease onset. Neurological examination and electrocardiographic findings were normal. Chest computed tomography showed findings consistent with interstitial pneumonia. Arterial blood gas analysis showed low pO2, pCO2, and P/F ratio indicating hypocapnic hypoxemia, while patients did not show the expected compensatory heart rate increase. Such mechanism could have led to syncope. We speculate that SARS-CoV-2 could have caused angiotensin-converting enzyme-2 (ACE2) receptor internalization in the nucleus of the solitary tract (NTS), thus altering the baroreflex response and inhibiting the compensatory tachycardia during acute hypocapnic hypoxemia.

中文翻译：

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由于压力反射反应受损，SARS-CoV-2发作时出现晕厥

我们描述了在鼻咽拭子上通过逆转录酶-聚合酶链反应在SARS-CoV-2呈阳性反应的35例连续患者中的临床和实验室发现，这些鼻咽拭子在疾病发作时表现出一种或多种晕厥事件。神经系统检查和心电图检查均正常。胸部计算机断层扫描显示与间质性肺炎一致的发现。动脉血气分析显示pO2，pCO2和P / F比值低，表明低碳酸血症性低氧血症，而患者并未表现出预期的代偿性心率升高。这种机制可能导致晕厥。我们推测，SARS-CoV-2可能会导致孤立区（NTS）核内的血管紧张素转换酶2（ACE2）受体内在化，