Study investigates long-term impact of COVID on the body’s autonomic system

When Calgary’s Dani Pohn, 37, contracted COVID-19 in June 2020, she didn’t dream she would still be dealing with the health impacts more than a year later.

But like many others with long-haul COVID-19, Pohn still struggles with extreme fatigue, exercise intolerance, debilitating brain fog and a racing heart (tachycardia). The symptoms have kept her from returning to work as a respiratory therapist and from doing many of the things she loves.  

“I didn’t have a severe case of COVID-19, and I was previously healthy,” says Pohn. “But this has had such a huge impact on my life in a lot of ways. All I want is to be able to have a full day without taking a nap.”

Pohn was part of the outbreak at a condo in downtown Calgary, and had symptoms like extreme fatigue, eye pain, headaches and a loss of smell. She rode out her illness at home and notes she had a mild-to-moderate bout of COVID-19. After three weeks, she slowly began to improve — at least for a while.

“I reached a plateau and realized nothing was changing,” she says. “I continued to feel exhausted, have shortness of breath and tachycardia that just hasn’t gone away.”

Pohn is now seeking treatment at a Calgary long-haul COVID-19 clinic, and at the Calgary Autonomic Investigation and Management Clinic at the Cumming School of Medicine (CSM), which treats individuals suffering with autonomic problems like tachycardia (rapid heartbeat), unregulated blood pressure and fainting.

Although she is frustrated with her ongoing symptoms, Pohn is keen to help others. She is a patient adviser for a study led by CSM researcher Dr. Satish Raj, MD. The research project, funded by the Canadian Institutes of Health Research, is investigating individuals suffering with autonomic problems after recovering from COVID-19.

Raj, a clinician-scientist within the Libin Cardiovascular Institute, has seen a marked increase in the number of individuals seeking treatment at the Calgary Autonomic Investigation and Management Clinic since the pandemic began.   

“We are getting significantly more referrals from the long-haul COVID clinics and physicians,” he says. “The number of people coming in with autonomic problems following COVID-19 infections is definitely noticeable.”

These long-haul patients are suffering with symptoms like rapid heartbeat, light-headedness, shortness of breath, exercise intolerance, memory and concentration problems, anxiety and depression, and fatigue, which hugely impact their quality of life.

“These are people in the prime of their life, highly functioning members of society who may no longer be able to contribute to the full extent of their training and prior ability,” says Raj. 

There have been more than 220 million cases and more than four million deaths attributed to COVID-19 worldwide. A vast majority of these individuals have recovered, but some, like Pohn, are left with ongoing symptoms for months following their acute COVID-19 infection.

According to Raj, the prevalence of disorders of the autonomic system, which controls things like blood pressure, breathing and heart rate, in long-haul COVID-19 patients isn’t known. Moreover, because the virus is novel, clinicians know little about how to best treat these individuals.  

Raj is hoping this study, with participating sites from across Canada, can lead to new insights on how common autonomic disorders are in these long-COVID patients.

These include disabling autonomic system disorders, such as orthostatic hypotension, which results in a drop in blood pressure on standing that can lead to fainting, or postural orthostatic tachycardia syndrome (POTS), with excessive heart rate increases with standing.

“We want to find out how common these problems are in the population, which is critical to help us to find viable treatments,” says Raj. “In many cases this can be debilitating, to the point that people can’t return to work, and there is still much we don’t understand about it.”

The study is currently recruiting. If you have long-COVID symptoms and are interested in participating in the study, you can find out more by emailing autonomic.research@ucalgary.ca.