Following on from the COVID-19 pandemic is another worldwide public health challenge that is referred to variously as long COVID, post-COVID syndrome or post-acute sequelae of SARS-CoV-2 infection (PASC). PASC comes in many forms and affects all body organs. This heterogeneous presentation suggests involvement of the autonomic nervous system (ANS), which has numerous roles in the maintenance of homeostasis and coordination of responses to various stressors. Thus far, studies of ANS dysregulation in people with PASC have been largely observational and descriptive, based on symptom inventories or objective but indirect measures of cardiovascular function, and have paid little attention to the adrenomedullary, hormonal and enteric nervous components of the ANS. Such investigations do not consider the syndromic nature of autonomic dysfunction. This Review provides an update on the literature relating to ANS abnormalities in people with post-COVID syndrome and presents a theoretical perspective on how the ANS might participate in common features of PASC.

继 COVID-19 大流行之后，又一个全球性公共卫生挑战被称为长期新冠肺炎、新冠肺炎后综合症或 SARS-CoV-2 感染后急性后遗症 (PASC)。PASC 有多种形式，影响所有身体器官。这种异质性的表现表明自主神经系统（ANS）的参与，它在维持体内平衡和协调对各种压力源的反应方面发挥着多种作用。迄今为止，对 PASC 患者 ANS 失调的研究主要是观察性和描述性的，基于症状清单或客观但间接的心血管功能测量，很少关注 ANS 的肾上腺髓质、激素和肠神经成分。此类研究并未考虑自主神经功能障碍的综合征性质。本综述提供了有关新冠肺炎后综合征患者 ANS 异常的文献更新，并提出了 ANS 如何参与 PASC 常见特征的理论观点。