Post-Covid-19 Tachycardia Syndrome, 2021; Ståhlberg, Fedorowski et al

Post-Covid-19 Tachycardia Syndrome: A distinct phenotype of Post-acute Covid-19 Syndrome

Ståhlberg, Fedorowski et al

Abstract
In this paper we highlight the presence of tachycardia in Post-acute Covid-19 Syndrome by introducing a new label for this phenomenon: Post-covid-19 tachycardia syndrome and argue that this constitutes a phenotype or sub-syndrome in PACS. We also discuss epidemiology, putative mechanisms, treatment options and future research directions in this novel clinical syndrome.

Highlights (Clinical Significance)

• Post-acute covid-19 syndrome is a novel clinical syndrome with symptoms beyond 4-12 weeks after a SARS-CoV-2 infection
  
  
• Tachycardia is commonly reported in these patients and may be considered a distinct phenotype
  
  
• Putative mechanism for tachycardia in this setting include dysautonomia
  
  
• Post-acute covid-19 syndrome patients reporting palpitations should be subjected to basic cardiovascular evaluation (including head-up TILT testing if concomitant orthostatic intolerance)
  
  
• Treatment options include cardiovascular drugs and structured rehabilitation program

https://www.amjmed.com/article/S0002-9343(21)00472-1/fulltext

 

https://twitter.com/user/status/1426809873430425603

 

Title : Anemia and iron metabolism in COVID-19: a systematic review and meta-analysis

Link : https://pubmed.ncbi.nlm.nih.gov/32816244/

Abstract

Iron metabolism and anemia may play an important role in multiple organ dysfunction syndrome in Coronavirus disease 2019 (COVID-19). We conducted a systematic review and meta-analysis to evaluate biomarkers of anemia and iron metabolism (hemoglobin, ferritin, transferrin, soluble transferrin receptor, hepcidin, haptoglobin, unsaturated iron-binding capacity, erythropoietin, free erythrocyte protoporphyrine, and erythrocyte indices) in patients diagnosed with COVID-19, and explored their prognostic value. Six bibliographic databases were searched up to August 3rd 2020. We included 189 unique studies, with data from 57,563 COVID-19 patients. Pooled mean hemoglobin and ferritin levels in COVID-19 patients across all ages were 129.7 g/L (95% Confidence Interval (CI), 128.51; 130.88) and 777.33 ng/mL (95% CI, 701.33; 852.77), respectively. Hemoglobin levels were lower with older age, higher percentage of subjects with diabetes, hypertension and overall comorbidities, and admitted to intensive care. Ferritin level increased with older age, increasing proportion of hypertensive study participants, and increasing proportion of mortality. Compared to moderate cases, severe COVID-19 cases had lower hemoglobin [weighted mean difference (WMD), - 4.08 g/L (95% CI - 5.12; - 3.05)] and red blood cell count [WMD, - 0.16 × 1012 /L (95% CI - 0.31; - 0.014)], and higher ferritin [WMD, - 473.25 ng/mL (95% CI 382.52; 563.98)] and red cell distribution width [WMD, 1.82% (95% CI 0.10; 3.55)]. A significant difference in mean ferritin levels of 606.37 ng/mL (95% CI 461.86; 750.88) was found between survivors and non-survivors, but not in hemoglobin levels. Future studies should explore the impact of iron metabolism and anemia in the pathophysiology, prognosis, and treatment of COVID-19.

If anemia and faulty iron metabolism increase the risk of someone catching Covid, it follows that it also might increase the risk of an individual developing Long Covid.

Iron deficiency, with or without anemia, increases the risk of palpitations and tachycardia. Perhaps going for the cheap and obvious (an iron panel) would be worth doing before spending lots of money on cardiovascular testing and investigation. And treating someone with low iron and/or anemia with sufficient iron supplements to raise their iron levels above the bottom 5% of the range might help too.

 

Agreed. Iron deficiency with or without anemia can cause palpitations and tachycardia.

As well, I recall something in a thread here about POTS that said low iron can worsen POTS.

 

So... dysautonomia. Which isn't necessarily POTS. But is clearly not new. Ugh.

This feels a lot like this, except dumber:

 

"Interview this Thursday with @ArturFedorowski who will kindly be answering a lot of questions from #LongCovid patients on Post Covid Tachycardia and dysautonomia. Will YouTube for all to access #COVID19 #FBLC #PoTS #PACS"

https://twitter.com/user/status/1430480340796248064