May 03, 2022;98 (18 Supplement) MONDAY, APRIL 4 Dysautonomia in Long Haul Covid-19 Infection Impairs Activities of Daily Living and Mental Health: The Patient Perspective

ABSTRACT

Objective: We report the burden of long haul COVID-19 associated dysautonomia and emphasize impact on activities of daily living and mental health, with the goal of developing interventions. Background: Dysautonomia is an established neurological effect of COVID-19 and has been reported in long-haul COVID-19 patients. It is imperative to understand the impact of this condition from the patient perspective to appreciate individual illness experience, clinical course, and disease burden to develop neurological, psychiatric, and social interventions. Design/Methods: 18 long-haul patients in a COVID-19 Remote Patient Monitoring Program (Precision Recovery Mount Sinai Health System) were interviewed regarding their experience with COVID-19. Patients were asked about their experiences navigating diagnoses, the health care system, and their recovery process, with emphasis on long-haul symptom course and impact. References to dysautonomia within their long haul COVID-19 experience (symptoms persisting greater than four weeks post initial infection) were analyzed for statistical and qualitative significance. Results: The following symptoms of long-haul COVID-19 dysautonomia were reported fluctuating fevers 12/18 (67%);heart palpitations/tachycardia 12/18 (67%);digestion problems 8/18 (44%);dizziness 6/18 (33%);and fluctuations in blood pressure 4/18 (22%). 7/18 (39%) of patients reported 3 or more dysautonmic symptoms. Patients reported three categories of impact on daily activities (1) routine physical exertion intolerance;(2) impaired ability to care for self (nutrition, hygiene);and (3) impacted social interaction due to physical impedance and/or isolation in experience. The main mental health effects associated with long-haul dysautonomia included (1) depression and suicide ideation, (2) intense anxiety, and (3) self doubt. Conclusions: Dysautonomia in long haul COVID-19 patients has a devastating impact on daily living and mental health. It is imperative to recognize these effects and understand them from the patient perspective in order to develop compassionate, validating, and efficacious neurological, psychological, and social interventions for this population.