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. 2023 Mar 1;33(2):e14-e15.
doi: 10.1097/JSM.0000000000001093. Epub 2022 Nov 6.

Patient-Centered Paradigm for Managing Autonomic Long COVID Symptoms During Sports and Exercise

Barbara Messinger-Rapport  1 , Blair Grubb  2   3
Affiliations

Patient-Centered Paradigm for Managing Autonomic Long COVID Symptoms During Sports and Exercise

Barbara Messinger-Rapport et al. Clin J Sport Med. .

Abstract

This report highlights a new, patient-centered paradigm for managing post-COVID-19 dysautonomia symptoms during sports and exercise. The patient was a healthcare worker exposed before vaccination. She experienced postural orthostatic tachycardia plus exertional tachycardia, with postexertional fatigue, beginning a few weeks after testing positive for COVID-19. Stress test, echo, and an extensive dysautonomia evaluation were negative. Recommended nonpharmacological and pharmacological interventions were poorly tolerated. Prescription of a novel regimen of "basal-dose" ivabradine, plus very low-dose metoprolol according to an exertional "sliding scale" managed symptoms to an acceptable level for work and recreation.

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Conflict of interest statement

The authors report no conflicts of interest.

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