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New research to be presented at this year's European Congress of Clinical Microbiology and Infectious Diseases (ececcmid, Lisbon, 23-26 April 2022) suggests that many symptoms are associated with post-covid syndrome (PCC, which may be linked to the virus) The vagus nerve is one of the most important multifunctional nerves in the body
.
The study was carried out by Drs Gemma Lladós and Lourdes Mateu, Trias i Pujol, German University Hospital, Badalona, Spain, and colleagues
The vagus nerve runs down from the brain to the trunk, heart, lungs, and intestines, as well as several muscles, including the swallowing muscles
.
As such, this nerve is responsible for a wide variety of bodily functions, including control of heart rate, speech, gag reflex, moving food from the mouth to the stomach, moving food through the intestines, sweating, and more
Long-term COVID-19 is a potentially disabling syndrome that affects an estimated 10-15% of COVID-19 survivors
.
The authors propose that SARS-CoV-2-mediated vagus nerve dysfunction (VND) may explain some of the long-standing COVID-19 symptoms, including dysphonia (persistent speech problems), dysphagia (dysphagia), dizziness, and tachycardia (abnormally high heart rate), orthostatic hypotension (low blood pressure), and diarrhea
The authors performed an initial, extensive morphological and functional assessment of the vagus nerve using imaging and functional testing in a prospective observational cohort of patients with prolonged coronavirus disease with symptoms of VND
.
Of the 348 patients, 228 (66%) had at least one symptom suggestive of VND
Of the 22 subjects, 20 (91%) were female, with a median age of 44 years
.
The most common VND-related symptoms were: diarrhea (73%), tachycardia (59%), dizziness, dysphagia and dysphonia (45% each) and orthostatic hypotension (14%)
Chest ultrasound revealed a flattened "diaphragmatic curve" (meaning decreased diaphragmatic activity during breathing, or more simply abnormal breathing) in 10 of 22 subjects (46%)
.
Ten of the 16 assessed (63%) showed a decrease in maximal inspiratory pressure, demonstrating respiratory muscle weakness
Diet and digestive function were also affected in some patients, and 13 of 18 patients (72%) screened positive for self-perceived oropharyngeal dysphagia (dysphagia)
.
Gastrointestinal function assessments of 19 patients showed impaired ability to transport food to the stomach (through the esophagus) in 8 patients (42%), with 2 patients (25%) reporting dysphagia
The Dysphonia Index 30 (a standard measure of speech function) test was abnormal in 8 of 17 (47%) cases, and 7 of these 8 (88%) had dysphonia
.
The authors said: "In this pilot assessment, the majority of prolonged COVID subjects with symptoms of vagal dysfunction had a range of significant, clinically relevant structural and/or functional changes in the vagus nerve, including nerve thickening, Dysphagia and dyspnea symptoms
.
Our findings to date suggest that vagal dysfunction is a major long-standing pathophysiological feature of COVID
Conference: European Congress of Clinical Microbiology and Infectious Diseases (ECCMID 2022)
