A case of dysautonomia after COVID-19 infection in a patient with poorly controlled type I diabetes

Abstract

COVID-19 has been linked to dysautonomia in the current literature, as has uncontrolled diabetes. Here, we present a case report of severe dysautonomia following a COVID-19 infection in a patient with pre-existing poorly controlled type-1 diabetes. This patient exhibited symptoms consistent with both postural orthostatic tachycardia syndrome (POTS), as well as orthostatic hypotension. His symptoms became so severe that he was unable to come to a standing position without experiencing syncope. Extensive workup was completed to identify an alternative cause of his dysautonomia with inconclusive results. Dysautonomia can have devastating consequences in regard to physical, social, and psychological health. Counseling individuals with poorly controlled diabetes about the importance of maintaining tight blood glucose control and avoiding COVID-19 infection should be primary interventions when treating patients with this DM1. Early detection and management of diabetes mellitus, COVID-19, and of possible resultant dysautonomia through medical interventions, as well as lifestyle changes, are extremely important measures to avoid development of dangerous and potentially life-threatening consequences.

Keywords: COVID‐19; dysautonomia; orthostatic hypotension; postural orthostatic tachycardia syndrome; type I diabetes.