Mexican singer Yuri revealed that, about a year after covid-19, she still suffers consequences caused by the disease.
She said she was diagnosed with dysautonomia – a normally rare condition that causes an uncomfortable and rapid increase in heart rate when a person tries to engage in any form of activity.
“Some sequelae in the nervous system (…) came back three weeks ago, I was very sick. Thank God I managed to detect it in time, I went to a neurologist, two neurologists, who detected that I have dysautonomia, which is not fatal, but it is very difficult,” he told the program today of the Mexican network Televisa.
But what exactly is this condition that affects the singer’s health and that has been detected in many other people who suffer from the so-called long covid?
Impact on automatic body functions
Dysautonomy is a general term that encompasses different conditions that share a common problem: the malfunction of the autonomic nervous system (ANS).
The ANS (made up of the sympathetic and parasympathetic systems) controls the body’s automatic functions – those over which we have no control – such as heart rate, blood pressure, digestion, pupil dilation and temperature, among others.
In a healthy person, the ANS responds correctly to external stimuli such as gravity, temperature or stress.
But when there are failures in the functioning of the autonomic nervous system, as with dysautonomia, the patient may present a series of symptoms ranging from dizziness, fainting, tachycardia, bradycardia (when the heart works slower), weakness, stomach problems, among others.
Dysautonomia can manifest as a primary condition or associated with other diseases such as Parkinson’s disease, rheumatoid arthritis or, as is starting to become evident, also with covid-19.
Dysautonomy can be present at birth or appear gradually or suddenly at any age. And its severity level ranges from mild to severe, but it is rarely fatal.
It is estimated that, worldwide, more than 70 million people live with various forms of this condition, which equally affects people of different genders and ethnicities.
In patients with long covid, fatigue is the most common clinical manifestation.
It remains a mystery why some patients who were infected with SARS-CoV-2 continue to have symptoms months after overcoming the disease, regardless of whether they suffered from severe or mild covid-19.
An autoimmune response to the initial viral infection may also be linked to another theory that tries to explain the long covid and may be the cause of some of the rarer symptoms, such as dysautonomia.
Some scientists consider covid-19 to be an endothelial disease, in which inflammation generated against the virus ends up damaging the vascular endothelium, a fragile layer that acts as an interface between blood and body tissues.
Earlier this year, scientists at the University of Copenhagen proposed that, in some patients with long covids, the body could end up attacking its own vascular structures.
Other scientists suspect that covid may trigger the reactivation of viruses that have been dormant in the body for years or even decades, and that this would lead to the development of chronic symptoms.
There is currently no cure for dysautonomy.
But in the secondary forms of the disease there can be improvements when the underlying condition is treated with medication, as well as exercise and changes in diet and lifestyle.
Amy Kontorovich, a cardiologist at Mount Sinai Hospital who specializes in treating dysautonomia, has developed a new physical therapy program known as Autonomic Conditioning Therapy (ACT) that has been shown to reduce fatigue symptoms in some patients with long covid and has since been adopted by 53 physical therapy centers across the New York area.
Kontorovich explains that the ACT starts with range-of-motion exercises, before progressing to different aerobic exercises that slowly increase in intensity but never allow the patient to exceed 85% of their maximum heart rate.
The technique is inspired by a similar reconditioning program, which has been shown to be effective in treating a form of dysautonomia, known as POTS, meaning orthostatic postural tachycardia syndrome.
“It seems to program the autonomic nervous system to reconnect things,” she says.
“One of the interesting trends I’ve seen in many of the long covid patients I’ve treated is that they were previously very active and, during the period of their acute illness, they were either lying in bed or mostly sedentary. This period of inactivity may be a factor in contributes to the pattern of post-covid dysautonomy, as we know it can happen with deconditioning.”
The specialist admits, however, that some of the patients with severe dysautonomia often cannot complete the program because they do not feel well.
But its first results show that it can be beneficial for those who can complete it.
On the other hand, it should be remembered that many patients who experience symptoms long after being infected with the virus begin to feel better over time as the body recovers.
And because SARS-CoV-2 has been with us for less than two years, it’s too early to know how long chronic symptoms will last.
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