The autonomic nervous system (ANS) can be affected by COVID-19, and dysautonomia may be a possible complication in post-COVID individuals. Orthostatic hypotension (OH) and postural tachycardia syndrome (POTS) have been suggested to be common after SARS-CoV-2 infection, but other components of ANS function may be also impaired. The Composite Autonomic Symptom Scale 31 (COMPASS-31) questionnaire is a simple and validated tool to assess dysautonomic symptoms. The aim of the present study was to administer the COMPASS-31 questionnaire to a sample of post-COVID patients with and without neurological complaints. Participants were recruited among the post-COVID ambulatory services for follow-up evaluation between 4 weeks and 9 months from COVID-19 symptoms onset. Participants were asked to complete the COMPASS-31 questionnaire referring to the period after COVID-19 disease. Heart rate and blood pressure were manually taken during an active stand test for OH and POTS diagnosis. One-hundred and eighty participants were included in the analysis (70.6% females, 51 ± 13 years), and OH was found in 13.8% of the subjects. Median COMPASS-31 score was 17.6 (6.9-31.4), with the most affected domains being orthostatic intolerance, sudomotor, gastrointestinal and pupillomotor dysfunction. A higher COMPASS-31 score was found in those with neurological symptoms (p < 0.01), due to more severe orthostatic intolerance symptoms (p < 0.01), although gastrointestinal (p < 0.01), urinary (p < 0.01), and pupillomotor (p < 0.01) domains were more represented in the non-neurological symptoms group. This study confirms the importance of monitoring ANS symptoms as a possible complication of COVID-19 disease that may persist in the post-acute period.

中文翻译：

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COVID 后伴有和不伴有神经系统症状的患者的自主神经功能障碍：一项前瞻性多领域观察研究。

自主神经系统 (ANS) 可能会受到 COVID-19 的影响，自主神经功能障碍可能是 COVID-19 后个体可能出现的并发症。直立性低血压 (OH) 和体位性心动过速综合征 (POTS) 被认为在 SARS-CoV-2 感染后很常见，但 ANS 功能的其他成分也可能受损。复合自主症状量表 31 (COMPASS-31) 问卷是评估自主神经症状的简单且经过验证的工具。本研究的目的是对有和没有神经系统疾病的 COVID 后患者样本进行 COMPASS-31 问卷调查。在 COVID-19 症状出现后 4 周至 9 个月期间，参与者被招募到 COVID 后门诊服务中进行后续评估。参与者被要求完成关于 COVID-19 疾病后时期的 COMPASS-31 问卷。在 OH 和 POTS 诊断的主动站立测试期间手动测量心率和血压。分析中包括 180 名参与者（70.6% 的女性，51 ± 13 岁），13.8% 的受试者发现 OH。中位 COMPASS-31 评分为 17.6 (6.9-31.4)，受影响最大的领域是直立性不耐受、促汗、胃肠道和瞳孔运动功能障碍。由于更严重的直立不耐受症状（p < 0.01），尽管胃肠道（p < 0.01）、泌尿系统（p < 0.01）和瞳孔运动（ p < 0.01) 域在非神经系统症状组中的代表性更高。