Cardiorespiratory dysautonomia in post-COVID-19 condition: Manifestations, mechanisms and management

A significant proportion of COVID-19 patients experience debilitating symptoms for months after the acute infection. According to recent estimates, approximately one out of ten COVID-19 convalescents reports persistent health issues more than three months after initial recovery. This "post-COVID-19 condition" may include a large variety of symptoms from almost all domains and organs, and for some patients it may mean prolonged sick-leave, homestay, and strongly limited activities of daily life. In this narrative review, we focus on the symptoms and signs of post-COVID-19 condition in adults-particularly those associated with cardiovascular and respiratory systems, such as postural orthostatic tachycardia syndrome (POTS) or airway disorders-and explore the evidence for chronic autonomic dysfunction as a potential underlying mechanism. The most plausible hypotheses regarding cellular and molecular mechanisms behind the wide spectrum of observed symptoms-such as lingering viruses, persistent inflammation, impairment in oxygen sensing systems and circulating antibodies directed to blood pressure regulatory components-are discussed. In addition, an overview of currently available pharmacological and non-pharmacological treatment options is presented. This article is protected by copyright. All rights reserved.