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Beyond POTS, autonomic dysfunction in long COVID can present as: Dysregulated sweating Impaired gastrointestinal muscle contractions, causing constipation, pain, nausea, or weight loss Temperature dysregulation An exaggerated fight-or-flight response The vagus nerve within this systemthe primary parasympathetic nerve connecting the brain to the gut, heart, and lungsappears to be particularly vulnerable to COVID-19-related damage, with implications for heart rate variability, gut function, and the inflammatory regulatory role the vagus nerve normally performs

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Bull Exp Biol Med 165:653656