Syncope at SARS-CoV-2 onset
Copyright © 2020. Published by Elsevier B.V..
We describe clinical and laboratory findings in 35 patients tested positive for SARS-CoV-2 by reverse transcriptase-polymerase chain reaction on nasopharyngeal swab experiencing one or multiple syncope at disease onset. Clinical neurologic and cardiologic examination, and electrocardiographic findings were normal. Chest computed tomography showed findings consistent with interstitial pneumonia. Arterial blood gas analysis showed low pO2, pCO2, and ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2) indicating hypocapnic hypoxemia. Patients who presented with syncope showed significantly lower heart rate as compared to 68 SARS-CoV-2 positive that did not. Such poorer than expected compensatory heart rate increase may have led to syncope based on individual susceptibility. We speculate that SARS-CoV-2 could have caused angiotensin-converting enzyme-2 (ACE2) receptor internalization in the nucleus of the solitary tract and other midbrain nuclei, impairing baroreflex and chemoreceptor response, and inhibiting the compensatory tachycardia during acute hypocapnic hypoxemia.
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2020 |
---|---|
Erschienen: |
2020 |
Enthalten in: |
Zur Gesamtaufnahme - volume:229 |
---|---|
Enthalten in: |
Autonomic neuroscience : basic & clinical - 229(2020) vom: 25. Dez., Seite 102734 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Canetta, Ciro [VerfasserIn] |
---|
Links: |
---|
Themen: |
Angiotensin-converting enzyme-2 (ACE2) receptor |
---|
Anmerkungen: |
Date Completed 10.12.2020 Date Revised 29.03.2024 published: Print-Electronic Citation Status MEDLINE |
---|
doi: |
10.1016/j.autneu.2020.102734 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM315478594 |
---|
LEADER | 01000caa a22002652 4500 | ||
---|---|---|---|
001 | NLM315478594 | ||
003 | DE-627 | ||
005 | 20240329235348.0 | ||
007 | cr uuu---uuuuu | ||
008 | 231225s2020 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1016/j.autneu.2020.102734 |2 doi | |
028 | 5 | 2 | |a pubmed24n1355.xml |
035 | |a (DE-627)NLM315478594 | ||
035 | |a (NLM)32977101 | ||
035 | |a (PII)S1566-0702(20)30168-5 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Canetta, Ciro |e verfasserin |4 aut | |
245 | 1 | 0 | |a Syncope at SARS-CoV-2 onset |
264 | 1 | |c 2020 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Completed 10.12.2020 | ||
500 | |a Date Revised 29.03.2024 | ||
500 | |a published: Print-Electronic | ||
500 | |a Citation Status MEDLINE | ||
520 | |a Copyright © 2020. Published by Elsevier B.V. | ||
520 | |a We describe clinical and laboratory findings in 35 patients tested positive for SARS-CoV-2 by reverse transcriptase-polymerase chain reaction on nasopharyngeal swab experiencing one or multiple syncope at disease onset. Clinical neurologic and cardiologic examination, and electrocardiographic findings were normal. Chest computed tomography showed findings consistent with interstitial pneumonia. Arterial blood gas analysis showed low pO2, pCO2, and ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2) indicating hypocapnic hypoxemia. Patients who presented with syncope showed significantly lower heart rate as compared to 68 SARS-CoV-2 positive that did not. Such poorer than expected compensatory heart rate increase may have led to syncope based on individual susceptibility. We speculate that SARS-CoV-2 could have caused angiotensin-converting enzyme-2 (ACE2) receptor internalization in the nucleus of the solitary tract and other midbrain nuclei, impairing baroreflex and chemoreceptor response, and inhibiting the compensatory tachycardia during acute hypocapnic hypoxemia | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Angiotensin-converting enzyme-2 (ACE2) receptor | |
650 | 4 | |a Baroreceptor reflex | |
650 | 4 | |a Central chemoreceptors | |
650 | 4 | |a Hypocapnic hypoxemia | |
650 | 4 | |a SARS-CoV-2 | |
650 | 4 | |a Syncope | |
700 | 1 | |a Accordino, Silvia |e verfasserin |4 aut | |
700 | 1 | |a Buscarini, Elisabetta |e verfasserin |4 aut | |
700 | 1 | |a Benelli, Gianpaolo |e verfasserin |4 aut | |
700 | 1 | |a La Piana, Giuseppe |e verfasserin |4 aut | |
700 | 1 | |a Scartabellati, Alessandro |e verfasserin |4 aut | |
700 | 1 | |a Viganò, Giovanni |e verfasserin |4 aut | |
700 | 1 | |a Assandri, Roberto |e verfasserin |4 aut | |
700 | 1 | |a Astengo, Alberto |e verfasserin |4 aut | |
700 | 1 | |a Benzoni, Chiara |e verfasserin |4 aut | |
700 | 1 | |a Gaudiano, Gianfranco |e verfasserin |4 aut | |
700 | 1 | |a Cazzato, Daniele |e verfasserin |4 aut | |
700 | 1 | |a Rossi, Davide Sebastiano |e verfasserin |4 aut | |
700 | 1 | |a Usai, Susanna |e verfasserin |4 aut | |
700 | 1 | |a Tramacere, Irene |e verfasserin |4 aut | |
700 | 1 | |a Lauria, Giuseppe |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t Autonomic neuroscience : basic & clinical |d 2000 |g 229(2020) vom: 25. Dez., Seite 102734 |w (DE-627)NLM109431324 |x 1872-7484 |7 nnns |
773 | 1 | 8 | |g volume:229 |g year:2020 |g day:25 |g month:12 |g pages:102734 |
856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.autneu.2020.102734 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 229 |j 2020 |b 25 |c 12 |h 102734 |