ArticleAnnals of neurology2022
Multisystem Involvement in Post-Acute Sequelae of Coronavirus Disease 19.
Article in Annals of neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 4 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
72 citing papers in PubMed, 4 syntheses or guidelines pooled it, 112 citations in OpenAlex.
- Mapping cerebral blood flow in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and orthostatic intolerance: insights from a systematic review.Journal of translational medicine · 2025Pooled it
- Pooled it
- A systematic review and meta-analysis of neuropathic pain associated with coronavirus disease 2019.European journal of pain (London, England) · 2023Pooled it
- Use of Cardiopulmonary Exercise Testing to Evaluate Long COVID-19 Symptoms in Adults: A Systematic Review and Meta-analysis.JAMA network open · 2022Pooled it
- Comparisons between anosmia and ageusia with neurological symptoms and cardiorespiratory fitness among post-COVID-19 individuals: a cross-sectional study.Acta neurologica Belgica · 2026Article
- Dysautonomia and Postural Orthostatic Syndrome of Hypocapnia in Long COVID Syndrome.Journal of clinical medicine · 2026Article
- Cerebral arteriopathy and its role in persistent post-COVID headache and brain fog: a quantitative study.European archives of psychiatry and clinical neuroscience · 2026Article
- Letter to the Editor.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026Article
- Understanding the long-term neurological effects of SARS-CoV-2 infection.Nature reviews. Neurology · 2026Review
- Clinical and Immunovirological Characteristics Associated with Cardiovascular Dysautonomia in Long COVID.Journal of clinical medicine · 2026Article
- Comprehensive Immunophenotyping of Monocytes and Dendritic Cells Suggests Distinct Pathophysiology in Chronic Fatigue Syndrome and Long COVID.International journal of molecular sciences · 2026Article
- Orthostatic cerebral hypoperfusion syndrome: an uncommon cause of orthostatic intolerance in a patient with COVID-19.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026Article
- Autonomic dysfunction and quality of life in a cohort of neurology outpatients with post-acute sequelae of COVID-19, a two-year follow-up study.Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2026Article
- Immune correlates underlying small fiber neuropathy presenting as vaccine-associated post-acute SARS- coronavirus syndrome.Frontiers in immunology · 2026Article
- Shared autonomic phenotype of long COVID and myalgic encephalomyelitis/chronic fatigue syndrome.PloS one · 2026Article
- The effect of high-dose long-term therapy of intravenous immunoglobulins in autoimmune autonomic and sensory small fiber neuropathy: a retrospective open-label controlled study.Scientific reports · 2025Article
- Hypermobile Ehlers-Danlos Syndrome: Cerebrovascular, Autonomic and Neuropathic Features.American journal of medicine open · 2025Article
- Minimal Objective Autonomic Dysfunction in Long COVID.Journal of the American College of Cardiology · 2025Article
- Using Active Standing Orthostatic Stress Test to Assess Physiological Responses in Individuals with Long COVID: A Systematic Review.Journal of clinical medicine · 2025Review
- Neuroimmune pathophysiology of long COVID.Psychiatry and clinical neurosciences · 2025Review
12 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe purpose of this study was to describe cerebrovascular, neuropathic, and autonomic features of post-acute sequelae of coronavirus disease 2019 ((COVID-19) PASC).
methodsThis retrospective study evaluated consecutive patients with chronic fatigue, brain fog, and orthostatic intolerance consistent with PASC. Controls included patients with postural tachycardia syndrome (POTS) and healthy participants. Analyzed data included surveys and autonomic (Valsalva maneuver, deep breathing, sudomotor, and tilt tests), cerebrovascular (cerebral blood flow velocity [CBFv] monitoring in middle cerebral artery), respiratory (capnography monitoring), and neuropathic (skin biopsies for assessment of small fiber neuropathy) testing and inflammatory/autoimmune markers.
resultsNine patients with PASC were evaluated 0.8 ± 0.3 years after a mild COVID-19 infection, and were treated as home observations. Autonomic, pain, brain fog, fatigue, and dyspnea surveys were abnormal in PASC and POTS (n = 10), compared with controls (n = 15). Tilt table test reproduced the majority of PASC symptoms. Orthostatic CBFv declined in PASC (-20.0 ± 13.4%) and POTS (-20.3 ± 15.1%), compared with controls (-3.0 ± 7.5%, p = 0.001) and was independent of end-tidal carbon dioxide in PASC, but caused by hyperventilation in POTS. Reduced orthostatic CBFv in PASC included both subjects without (n = 6) and with (n = 3) orthostatic tachycardia. Dysautonomia was frequent (100% in both PASC and POTS) but was milder in PASC (p = 0.002). PASC and POTS cohorts diverged in frequency of small fiber neuropathy (89% vs 60%) but not in inflammatory markers (67% vs 70%). Supine and orthostatic hypocapnia was observed in PASC.
interpretationPASC following mild COVID-19 infection is associated with multisystem involvement including: (1) cerebrovascular dysregulation with persistent cerebral arteriolar vasoconstriction; (2) small fiber neuropathy and related dysautonomia; (3) respiratory dysregulation; and (4) chronic inflammation. ANN NEUROL 2022;91:367-379.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.