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COVID-19 may affect long-term; fight or flight; response in young adults

COVID-19 may affect long-term ‘fight or flight’ response in young adults

Share on Pinterest New research suggests that young people may experience changes to the sympathetic nervous system after recovering from COVID-19. Image credit: Mikhail TereshchenkoTASS via Getty Images

  • The sympathetic nervous system governs the “fight-or-flight” response.
  • A study suggests that young adults who recently recovered from COVID-19 have increased activity in this branch of their nervous system while at rest.
  • Compared with controls, they had higher sympathetic nerve activity and a faster heart rate in a test designed to simulate standing up.
  • If similar disturbances occur in older adults after COVID-19, there may be serious adverse effects on their cardiovascular health.

Around a third of otherwise healthy people who have recovered from mild COVID-19 experience the lingering symptoms of long COVID.

The most common symptoms include fatigue and shortness of breath, but some individuals also report heart palpitations.

This may be a sign that their “autonomic nervous system” is out of balance.

The two wings of the autonomic nervous system act together automatically to regulate vital functions such as heart rate and breathing.

Stay informed with live updates on the current COVID-19 outbreak and visit our coronavirus hub for more advice on prevention and treatment.

When the body perceives a life threatening situation, the sympathetic nervous system increases heart rate and breathing rate, a reaction that people call the “fight-or-flight response.”

By contrast, the parasympathetic nervous system restores the body to a more stable, restful state, known as “rest and digest.”

Individuals with hypertension (high blood pressure), diabetes, and obesity often have increased activity in their sympathetic nervous system, which COVID-19 may exacerbate.

For the first time, researchers have now assessed sympathetic nerve activity in otherwise healthy young people recovering from the infection.

They ran a series of tests on 16 individuals aged approximately 20 years old who had tested positive for SARS-CoV-2, the virus that causes COVID-19, around 35 days previously.

Before the pandemic, the scientists carried out identical tests on an age-matched group of 14 healthy volunteers, who served as controls.

The tests revealed changes in the sympathetic nervous system of people recovering COVID-19, both at rest and in response to a stress test.

There were also differences in heart rate and sympathetic nerve activity in a test designed to simulate standing up.

The researchers believe that the same changes in older adults could have adverse effects on their cardiovascular health.

“This is because, with aging, we tend to lose some of the compensatory mechanisms in place to offset the blood-pressure-raising effects of high sympathetic activity,” said senior author Dr. Abigail Stickford, from the department of health and exercise science at Appalachian State University in Boone, NC.

“Ultimately, this could also place more strain on the heart,” she told Medical News Today.

Х рей кросс последние новости на сегодня

To further secure cross-border travel and standardize the pre-departure health code application for passengers to China, the relevant adjustments are hereby notified by the Chinese Embassy as follows:

1. Further standardize the test certificates. Passengers flying from Singapore to China on and after 27 July(Tuesday) shall upload nucleic acid and IgM anti-body test certificates with verifiable QR code in advance to apply for health codes (see Annex 1).

2. Adjust and standardize the test and vaccination certificates of the vaccinated of COVID-19 vaccines.

2.1 Relevant requirements for passengers vaccinated with non-inactivated COVID-19 vaccines,eg. Pfizer-BioNTech/Comirnaty and Modena vaccines in Singapore and taking direct flights to China on and after 17 August (Tuesday):

a. Take the nucleic acid (PCR) and total serology antibody against N protein (hereinafter referred to as «PCR and N protein antibody tests») within 2 days before departure. IgM antibody test is not required any more. Passengers are eligible to apply for health codes if tested negative for PCR and N protein antibody testing. The format of the test certificate is attached as follows(see Annex 2). For name list of N protein antibody testing agencies, please refer to the attached FAQs on Pre-departure Tests and Health Code Application .

b. Upload the vaccination certificate with verifiable QR code (see Annex 3, and refer to the attached FAQs on Pre-departure Tests and Health Code Application for application procedures). Since it will take a certain period of time to apply for the certificate (14 days for now), please plan your itinerary to China accordingly.

For those who have been vaccinated in countries or regions other than China and Singapore, please follow the above-mentioned requirements for testing and provide vaccination certificates. For specific requirements of vaccination certificates, please refer to the official websites of the Chinese Embassy and Consulate General in the place of vaccination. Those who providing the unidentified or unverifiable vaccination certificates will be regarded as the unvaccinated.

2.2 Relevant requirements for passengers vaccinated with inactivated COVID-19 vaccines,eg. Sinovac and Sinopharm, and taking direct flights to China on or after 27 July (Tuesday):

a. If passengers have been vaccinated with inactivated vaccines in Singapore, please upload the vaccination records generated via the Health Hub (personal particulars and vaccination information shall be indicated in the records, please see Annex 4 and refer to the attached FAQs on Pre-departure Tests and Health Code Application for inquiry methods). Once the vaccination information is uploaded to the relevant program, the vaccination record can be accessed in the Health Hub. If passengers have been vaccinated with inactivated vaccines in China or other countries or regions, please continue to upload vaccination certificates indicating such information as the name of person, vaccine brand and place of vaccination.

b. Fill in and upload Letter of Commitment on COVID-19 Vaccination (see Annex 5).

c. In principle, passengers can take flights on or after 17 August (Tuesday) to China,providing that they have been fully vaccinated for 14 days. For example, if passengers have completed the second dose of vaccination on 1 September , they can take the flights on 15 September to China at the earliest.

3. The transition period

A transition period is offered regarding the above-mentioned requirements from the date of notice to the date of implementation. Within the transition period, passengers to China can take the pre-departure tests and submit the corresponding documents in accordance with the latest or previous requirements. After the transition period is over, the latest requirements will be strictly implemented.

4. Other requirements regarding the nucleic acid and serology tests remain unchanged. Passengers to China are kindly advised to refer to the relevant requirements at http://www.chinaembassy.org.sg/chn/lsfw/26511/, plan the itinerary accordingly, take the tests and upload the required documents. For more details, please refer to FAQs on Pre-departure Tests and Health Code Application (see Annex 6).

For Enquiry: +65-81296456 (8:30AM—12:00PM, 2:30PM—5:00PM, Monday—Friday, except Holidays)

Annex 1: Sample of verifiable nucleic acid and serology IgM antibody test certificates

Annex 2: Sample of verifiable nucleic acid and total antibody N protein certificates

Kerala’s daily Covid infections cross 30,000 for first time in 3 months

The Test Positivity Rate rose further on Wednesday and crossed the 19% mark, according to a state govt release

Press Trust of India | Thiruvananthapuram Last Updated at August 25, 2021 19:36 IST


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Kerala on Wednesday logged 31,445 fresh COVID-19 cases and 215 deaths, pushing the total infection count to 38,83,429 and the fatalities to 19,972 till date.

The last time the state crossed the 30,000 mark was on May 20 when it logged 30,491 cases.

The Test Positivity Rate (TPR) rose further on Wednesday and crossed the 19 per cent mark, according to a state government release.

After the Onam festivities, medical experts had predicted that the TPR would go beyond 20 per cent and that the number of infections would rise further.

Since July 27, after the Bakrid celebrations when restrictions were relaxed for a few days, Kerala has been logging more than or close to 20,000 cases on almost every day.

The release further said that as many as 20,271 people have been cured of the infection since Tuesday, taking the total recoveries to 36,92,628 and the number of active cases to 1,70,292.

In the last 24 hours, 1,65,273 samples were tested and the TPR was found to be 19.03 per cent. So far, 3,06,19,046 samples have been tested, it said.

Among districts, Ernakulam recorded the highest number with 4,048 cases, followed by Thrissur (3,865), Kozhikode (3,680), Malappuram (3,502), Palakkad (2,562), Kollam (2,479), Kottayam (2,050), Kannur (1,930) Alappuzha (1,874), Thiruvananthapuram (1,700), Idukki (1,166) Pathanamthitta (1,008) and Wayanad (962).

Of the new cases, 123 were health workers, 138 from outside the state and 29,608 infected through contact, with the source of the contact not being clear in 1,576 cases, the release said.

There are currently 4,70,860 people under surveillance in various districts. Of these, 4,44,278 are in home or institutional quarantine and 26,582 in hospitals.

(Only the headline and picture of this report may have been reworked by the Business Standard staff; the rest of the content is auto-generated from a syndicated feed.)

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Neck Sprain


What is a neck sprain?

A neck sprain is a stretched ligament or muscle in the neck. A neck sprain may occur without any obvious injury but sometimes it may be caused by a sudden impact with an object. An impact may force the neck to quickly extend beyond its normal range, and then snap back forcefully. This is commonly called a whiplash injury. Rear-end car accidents, head jerking during amusement park rides, or being kicked are the most common forms of impact that may cause a neck sprain.

Symptoms and Causes

What symptoms will I have with a neck sprain?

You will have neck pain that worsens with movement. Sometimes this pain will not appear until a full day or two after the event that caused it. You will most likely have neck stiffness that hinders your ability to move your neck. The back of your head might hurt. You may also have pain in the shoulders or upper back. Other symptoms that may happen with a neck sprain include:

  • Dizziness
  • Ringing in the ears
  • Fatigue
  • Patchy numbness in the hands or arms

If you notice these symptoms after a whiplash-type incident, see a doctor for an evaluation to rule out a more serious problem, such as damage to the spinal cord. Arm or leg weakness, difficulty walking, and an inability to control the bladder or bowels are signs of spinal cord injury. If you have immediate neck pain after the incident, go to an emergency room.

Diagnosis and Tests

How is a neck sprain diagnosed?

A physical examination will review your posture, ability to move, and the position of your head and chin. The doctor will inspect the blood vessels in your neck and may listen to them with a stethoscope. He or she also may check:

  • The range of motion of your neck
  • The muscle strength in your arms
  • Your reflexes
  • Whether or not you can detect sensations

Imaging tests such as X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI) may be used, but most people with suspected neck sprain do not need these tests.

An MRI is a painless, noninvasive test that produces very clear pictures, or images of the human body without the use of X-rays. MRI uses a large magnet, radio waves, and a computer to produce these images.

A CT scan is an X-ray procedure that combines many X-ray images with the help of a computer to create cross-sectional views of the body.

Management and Treatment

How is neck sprain treated?

Pain, inflammation, and tension may be treated by:

  • Analgesics and anti-inflammatory medications
  • Ice for the first 24 hours followed by heat applied to the neck through a moist towel
  • Muscle relaxants

Gentle movement of the neck is encouraged. Range of motion exercises may be prescribed by a physical therapist.

You may want to try sleeping with a rolled up towel under your neck for relief.

Outlook / Prognosis

What can I expect from treatment?

Your head and neck pain should get better within a couple of weeks. If not, local anesthetic injections may be tried. Full recovery may take as long as 3 months. If you are still having symptoms after this time further evaluation by a spine specialist is appropriate.

Last reviewed by a Cleveland Clinic medical professional on 01/22/2014.

  • American Academy of Orthopaedic Surgeons. Accessed 1/27/2014. Neck Sprain (http://orthoinfo.aaos.org/topic.cfm?topic=A00410)
  • Medline Plus. Accessed 1/27/2014. Neck Injuries and Disorders (http://www.nlm.nih.gov/medlineplus/neckinjuriesanddisorders.html)
  • American College of Rheumatology. Accessed 1/27/2014. Neck Pain (http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Neck_Pain/)

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

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