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Background:
Systematic Review

Autonomic Dysfunction during Acute SARS-CoV-2 Infection: A Systematic Review

by
Irene Scala
1,
Pier Andrea Rizzo
1,
Simone Bellavia
1,
Valerio Brunetti
2,
Francesca Colò
1,
Aldobrando Broccolini
1,2,
Giacomo Della Marca
1,2,
Paolo Calabresi
1,2,
Marco Luigetti
1,2,* and
Giovanni Frisullo
2
1
School of Medicine and Surgery, Catholic University of Sacred Heart, Largo Francesco Vito, 1, 00168 Rome, Italy
2
Dipartimento di Scienze dell’Invecchiamento, Neurologiche, Ortopediche e Della Testa-Collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2022, 11(13), 3883; https://doi.org/10.3390/jcm11133883
Submission received: 8 June 2022 / Revised: 29 June 2022 / Accepted: 29 June 2022 / Published: 4 July 2022
(This article belongs to the Special Issue Clinical Health Care during the COVID-19 Pandemic: Therapeutic and Management Strategies)
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Abstract

Although autonomic dysfunction (AD) after the recovery from Coronavirus disease 2019 (COVID-19) has been thoroughly described, few data are available regarding the involvement of the autonomic nervous system (ANS) during the acute phase of SARS-CoV-2 infection. The primary aim of this review was to summarize current knowledge regarding the AD occurring during acute COVID-19. Secondarily, we aimed to clarify the prognostic value of ANS involvement and the role of autonomic parameters in predicting SARS-CoV-2 infection. According to the PRISMA guidelines, we performed a systematic review across Scopus and PubMed databases, resulting in 1585 records. The records check and the analysis of included reports’ references allowed us to include 22 articles. The studies were widely heterogeneous for study population, dysautonomia assessment, and COVID-19 severity. Heart rate variability was the tool most frequently chosen to analyze autonomic parameters, followed by automated pupillometry. Most studies found ANS involvement during acute COVID-19, and AD was often related to a worse outcome. Further studies are needed to clarify the role of autonomic parameters in predicting SARS-CoV-2 infection. The evidence emerging from this review suggests that a complex autonomic nervous system imbalance is a prominent feature of acute COVID-19, often leading to a poor prognosis.
Keywords: COVID-19; SARS-CoV-2; dysautonomia; autonomic nervous system; autonomic dysfunction; heart rate variability; outcome; prognosis COVID-19; SARS-CoV-2; dysautonomia; autonomic nervous system; autonomic dysfunction; heart rate variability; outcome; prognosis

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MDPI and ACS Style

Scala, I.; Rizzo, P.A.; Bellavia, S.; Brunetti, V.; Colò, F.; Broccolini, A.; Della Marca, G.; Calabresi, P.; Luigetti, M.; Frisullo, G. Autonomic Dysfunction during Acute SARS-CoV-2 Infection: A Systematic Review. J. Clin. Med. 2022, 11, 3883. https://doi.org/10.3390/jcm11133883

AMA Style

Scala I, Rizzo PA, Bellavia S, Brunetti V, Colò F, Broccolini A, Della Marca G, Calabresi P, Luigetti M, Frisullo G. Autonomic Dysfunction during Acute SARS-CoV-2 Infection: A Systematic Review. Journal of Clinical Medicine. 2022; 11(13):3883. https://doi.org/10.3390/jcm11133883

Chicago/Turabian Style

Scala, Irene, Pier Andrea Rizzo, Simone Bellavia, Valerio Brunetti, Francesca Colò, Aldobrando Broccolini, Giacomo Della Marca, Paolo Calabresi, Marco Luigetti, and Giovanni Frisullo. 2022. "Autonomic Dysfunction during Acute SARS-CoV-2 Infection: A Systematic Review" Journal of Clinical Medicine 11, no. 13: 3883. https://doi.org/10.3390/jcm11133883

APA Style

Scala, I., Rizzo, P. A., Bellavia, S., Brunetti, V., Colò, F., Broccolini, A., Della Marca, G., Calabresi, P., Luigetti, M., & Frisullo, G. (2022). Autonomic Dysfunction during Acute SARS-CoV-2 Infection: A Systematic Review. Journal of Clinical Medicine, 11(13), 3883. https://doi.org/10.3390/jcm11133883

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