Autonomic Dysfunction in Patients with Acute Infection with Coxiella burnetii 2026 Petrovic et al

[Andy]

Abstract​

Background: Coxiella burnetii is a common zoonotic pathogen that can lead not only to acute or chronic Q fever but also to post-infectious syndromes, where autonomic nervous system (ANS) dysfunction has been suggested as a contributing mechanism. This study aimed to assess autonomic function in patients presenting with polymorphic symptoms, dysautonomia, or ME/CFS who had serological evidence of acute infection with Coxiella burnetii.

Methods: A total of 156 participants were evaluated, including 100 seropositive patients and 56 matched controls. All subjects underwent standardized cardiovascular reflex tests (CART), beat-to-beat analysis of heart rate and blood pressure with baroreflex indices, 24 h Holter ECG with HRV assessment, and, in the Coxiella group, head-up tilt testing (HUTT).

Results: A significantly higher prevalence of autonomic dysfunction was observed in the Coxiella group, predominantly affecting parasympathetic regulation, with abnormal CART scores, reduced LF power and baroreflex effectiveness, and a high rate of positive HUTT findings characterized by extreme blood pressure variability. Although long-term HRV measures did not differ significantly between groups, short-term indices consistently indicated ANS impairment.

Conclusions: These findings suggest that Coxiella burnetii infection may trigger persistent autonomic dysfunction, potentially contributing to the development of ME/CFS and syncope in affected individuals. Further longitudinal studies are needed to clarify pathophysiological mechanisms and clinical implications.

Open access

 

[Utsikt]

These findings suggest that Coxiella burnetii infection may trigger persistent autonomic dysfunction, potentially contributing to the development of ME/CFS and syncope in affected individuals.

That seems like a bit of a stretch. «Associated with» might have been fine. To jump to causation is not.

 

[Yann04]

That seems like a bit of a stretch. «Associated with» might have been fine. To jump to causation is not.

it’s unclear to me based on the phrasing if they mean the PI-autonomic dysfunction or the infection itself may be casual?

 

[Utsikt]

it’s unclear to me based on the phrasing if they mean the PI-autonomic dysfunction or the infection itself may be casual?

I agree that it’s a bit unclear, but I read it as «Infection might trigger autonomic dysfunction, and autonomic dysfunction might contribute to ME/CFS»

If they wanted to say that the infection might cause autonomic dysfunction, syncope, and ME/CFS, they could have said it like that with a list.