The potential role of vagus nerve dysfunction and dysautonomia in long COVID

Long COVID is an established and relatively common consequence of COVID-19, whereas its debilitating symptoms may impact recoverees for prolonged periods [ 1 Yelin D. Moschopoulos C.D. Margalit I. Gkrania-Klotsas E. Landi F. Stahl J.P. et al. ESCMID rapid guidelines for assessment and management of long COVID. Clin Microbiol Infect. 2022; 28: 955-972https://doi.org/10.1016/j.cmi.2022.02.018 Abstract Full Text Full Text PDF PubMed Scopus (65) Google Scholar ]. Despite over 2 years of research, the pathophysiology of long COVID remains unclear, hindering the development of effective therapeutic interventions. Re: 'Vagus nerve dysfunction in the post-COVID-19 condition' by Lladós et al.Clinical Microbiology and InfectionPreviewWe read with interest Llados et al.'s [1] article on a cross-sectional pilot study on the 10th cranial nerve (10CN) and phrenic nerve (PN) function and morphology in 30 patients with post-COVID condition (PCC), conducted between September 2021 and March 2022. To test the function and morphology of these two nerves, several tests were performed [1]. It was found that patients with PCC had a higher frequency of 10CN thickening and hyperechogenicity, decreased esophagogastric peristalsis, gastroesophageal reflux, hiatal hernia, flattened hemidiaphragm, and decreased peak inspiratory pressure compared to controls [1]. Full-Text PDF Vagus nerve dysfunction in the post–COVID-19 condition: a pilot cross-sectional studyClinical Microbiology and InfectionVol. 30Issue 4PreviewThe post–COVID-19 condition (PCC) is a disabling syndrome affecting at least 5%–10% of subjects who survive COVID-19. SARS-CoV-2 mediated vagus nerve dysfunction could explain some PCC symptoms, such as dysphonia, dysphagia, dyspnea, dizziness, tachycardia, orthostatic hypotension, gastrointestinal disturbances, or neurocognitive complaints. Full-Text PDF Open AccessVagus nerve dysfunction in the post-COVID-19 condition: author's responseClinical Microbiology and InfectionPreviewWe sincerely thank Dr Finsterer [1] for his insightful comments. First, we would like to highlight that is a pilot study with a small number of participants, intended to formulate hypotheses regarding the potential impact on the vagus nerve in some symptoms manifested in post-covid condition (PCC) [2]. Full-Text PDF