Dolphin
Senior Member (Voting Rights)
Preprint now published. See post #6
https://www.medrxiv.org/content/10.1101/2023.12.18.23299958v1
Prevalence of orthostatic intolerance in Long Covid clinic patients – A multicentre observational study
Cassie Lee1(0009-0004-9449-0932) Darren C Greenwood2, Harsha Master3, Kumaran Balasundaram4, Paul Williams3, Janet T. Scott5,6, Conor Wood7, Rowena Cooper5, Julie L. Darbyshire8, Ana Espinosa Gonzalez9, Helen E. Davies10, Thomas Osborne11, Joanna Corrado11, Nafi Iftekhar11, Natalie Rogers12, Brendan Delaney9, Trish Greenhalgh8, Manoj
Sivan11 on behalf of the LOCOMOTION Consortium
1 Imperial College Healthcare NHS Trust, London, UK
2 School of Medicine, University of Leeds, Leeds, UK
3 Covid assessment and rehabilitation service, Hertfordshire Community NHS Trust, Welwyn Garden City, UK
4 NIHR Leicester Biomedical Research Centre – Respiratory & Infection Theme, Glenfield Hospital, Leicester, UK
5 Development and Innovation Department, NHS Highlands, Inverness, UK.
6 MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
7 Birmingham Community Healthcare, Birmingham, UK
8 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
9 Faculty of Medicine, Department of Surgery & Cancer, Imperial College, London, UK
10 Department of Respiratory Medicine, University Hospital of Wales, Cardiff, UK
11 Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, UK
12 Person with experience of long Covid and member of the LOCOMOTION Patient Advisory Group
Abstract
Purpose:
Orthostatic intolerance (OI), including postural orthostatic tachycardia syndrome (PoTS) and orthostatic hypotension (OH), are often reported in long covid, but published studies are small with inconsistent results.
We sought to estimate the prevalence of objective OI in patients attending long covid clinics and healthy volunteers and associations with symptoms and comorbidities.
Methods:
Participants were recruited from 8 UK long covid clinics, and healthy volunteers from general population.
All undertook standardised National Aeronautics and Space Administration Lean Test (NLT).
Participants history of typical OI symptoms (e.g. dizziness, palpitations) prior to and during the NLT were recorded.
Results:
277 long covid patients and 50 frequency-matched healthy volunteers were tested.
Healthy volunteers had no history of OI symptoms or PoTS, 10% had asymptomatic OH. 130 (47%) long covid patients had previous history of OI symptoms and 144 (52%) developed symptoms during the NLT.
41 (15%) had abnormal NLT, 20 (7%) met criteria for PoTS and 21 (8%) had OH.
Of patients with an abnormal NLT, 45% had no prior symptoms of OI.
Relaxing the diagnostic thresholds for PoTS from two consecutive to one reading, resulted in 11% of long covid participants meeting criteria for PoTS, but not in healthy volunteers.
Conclusion:
More than half of long covid patients experienced OI symptoms during NLT and more than one in ten patients met the criteria for either PoTS or OH, half of whom did not report previous typical OI symptoms.
We recommend all patients attending long covid clinics are offered an NLT and appropriate management commenced.
https://www.medrxiv.org/content/10.1101/2023.12.18.23299958v1
Prevalence of orthostatic intolerance in Long Covid clinic patients – A multicentre observational study
Cassie Lee1(0009-0004-9449-0932) Darren C Greenwood2, Harsha Master3, Kumaran Balasundaram4, Paul Williams3, Janet T. Scott5,6, Conor Wood7, Rowena Cooper5, Julie L. Darbyshire8, Ana Espinosa Gonzalez9, Helen E. Davies10, Thomas Osborne11, Joanna Corrado11, Nafi Iftekhar11, Natalie Rogers12, Brendan Delaney9, Trish Greenhalgh8, Manoj
Sivan11 on behalf of the LOCOMOTION Consortium
1 Imperial College Healthcare NHS Trust, London, UK
2 School of Medicine, University of Leeds, Leeds, UK
3 Covid assessment and rehabilitation service, Hertfordshire Community NHS Trust, Welwyn Garden City, UK
4 NIHR Leicester Biomedical Research Centre – Respiratory & Infection Theme, Glenfield Hospital, Leicester, UK
5 Development and Innovation Department, NHS Highlands, Inverness, UK.
6 MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
7 Birmingham Community Healthcare, Birmingham, UK
8 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
9 Faculty of Medicine, Department of Surgery & Cancer, Imperial College, London, UK
10 Department of Respiratory Medicine, University Hospital of Wales, Cardiff, UK
11 Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, UK
12 Person with experience of long Covid and member of the LOCOMOTION Patient Advisory Group
Abstract
Purpose:
Orthostatic intolerance (OI), including postural orthostatic tachycardia syndrome (PoTS) and orthostatic hypotension (OH), are often reported in long covid, but published studies are small with inconsistent results.
We sought to estimate the prevalence of objective OI in patients attending long covid clinics and healthy volunteers and associations with symptoms and comorbidities.
Methods:
Participants were recruited from 8 UK long covid clinics, and healthy volunteers from general population.
All undertook standardised National Aeronautics and Space Administration Lean Test (NLT).
Participants history of typical OI symptoms (e.g. dizziness, palpitations) prior to and during the NLT were recorded.
Results:
277 long covid patients and 50 frequency-matched healthy volunteers were tested.
Healthy volunteers had no history of OI symptoms or PoTS, 10% had asymptomatic OH. 130 (47%) long covid patients had previous history of OI symptoms and 144 (52%) developed symptoms during the NLT.
41 (15%) had abnormal NLT, 20 (7%) met criteria for PoTS and 21 (8%) had OH.
Of patients with an abnormal NLT, 45% had no prior symptoms of OI.
Relaxing the diagnostic thresholds for PoTS from two consecutive to one reading, resulted in 11% of long covid participants meeting criteria for PoTS, but not in healthy volunteers.
Conclusion:
More than half of long covid patients experienced OI symptoms during NLT and more than one in ten patients met the criteria for either PoTS or OH, half of whom did not report previous typical OI symptoms.
We recommend all patients attending long covid clinics are offered an NLT and appropriate management commenced.
Last edited by a moderator: