Background

Syncope is not a common manifestation of COVID-19, but it may occur in this context and it can be the presenting symptom in some cases. Different mechanisms may explain the pathophysiology behind COVID-19 related syncope. In this report, we aimed to examine the current frequency and etiology of syncope in COVID-19.

Methods

A systematic review across PubMed, ISI Web of Knowledge and SCOPUS was performed, according to PRISMA guidelines, in order to identify all relevant articles regarding both COVID-19 and syncope.

Results

We identified 136 publications, of which 99 were excluded. The frequency of syncope and pre-syncope across the selected studies was 4.2% (604/14,437). Unexplained syncope was the most common type (87.9% of the episodes), followed by reflex syncope (7.8% of the cases). Orthostatic hypotension was responsible for 2.2% of the cases and syncope of presumable cardiac cause also accounted for 2.2% of cases. Arterial hypertension was present in 52.0% of syncope patients. Neither the use of angiotensin receptor blockers nor angiotensin converting enzyme inhibitors were associated with an increased incidence of syncope (chi-square test 1.07, p 0.30), unlike the use of beta-blockers (chi-square test 12.48, p < 0.01).

Conclusion

Syncope, although not considered a typical symptom of the COVID-19, can be associated with it, particularly in early stages. Different causes of syncope were seen in this context. A reevaluation of blood pressure in patients with COVID-19 is suggested, including reassessment of antihypertensive therapy, especially in the case of beta-blockers.

中文翻译：

---

晕厥和 COVID-19 疾病——系统评价

背景

晕厥不是 COVID-19 的常见表现，但它可能会在这种情况下发生，并且在某些情况下可能是主诉症状。不同的机制可以解释 COVID-19 相关晕厥背后的病理生理学。在本报告中，我们旨在检查 COVID-19 中晕厥的当前频率和病因。

方法

根据 PRISMA 指南，对 PubMed、ISI Web of Knowledge 和 SCOPUS 进行了系统审查，以确定所有关于 COVID-19 和晕厥的相关文章。

结果

我们确定了 136 篇出版物，其中 99 篇被排除在外。所选研究中晕厥和先兆晕厥的发生率为 4.2% (604/14,437)。不明原因晕厥是最常见的类型（87.9% 的发作），其次是反射性晕厥（7.8% 的病例）。直立性低血压占 2.2% 的病例，而可能的心脏原因引起的晕厥也占 2.2% 的病例。52.0% 的晕厥患者存在动脉高血压。使用血管紧张素受体阻滞剂和血管紧张素转换酶抑制剂均与晕厥发生率增加无关（卡方检验 1.07，p = 0.30），这与使用 β 受体阻滞剂不同（卡方检验 12.48，p < 0.01）。

结论

晕厥虽然不被认为是 COVID-19 的典型症状，但可能与之相关，尤其是在早期阶段。在这种情况下，出现了不同的晕厥原因。建议重新评估 COVID-19 患者的血压，包括重新评估抗高血压治疗，尤其是在使用 β 受体阻滞剂的情况下。