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During the first pandemic year, the number of performed tilt\u2010table tests, autonomic outpatient and inpatient visits decreased respectively by 50%, 45% and 53%, and every third center reported major adverse events due to postponed examinations or visits. The most frequent newly diagnosed or worsened cardiovascular autonomic disorders after COVID\u201019 infection included postural orthostatic tachycardia syndrome, orthostatic hypotension and recurrent vasovagal syncope, deemed to be likely related to the infection by \u226550% of the responders. Forty\u2010seven percent of the responders also reported about people with new onset of orthostatic intolerance but negative tilt\u2010table findings, and 16% about people with psychogenic pseudosyncope after COVID\u201019. Most patients were treated non\u2010pharmacologically and symptomatic recovery at follow\u2010up was observed in \u226545% of cases. By contrast, low frequencies of newly diagnosed cardiovascular autonomic disorders following COVID\u201019 vaccination were reported, most frequently postural orthostatic tachycardia syndrome and recurrent vasovagal syncope, and most of the responders judged a causal association unlikely. Non\u2010pharmacological measures were the preferred treatment choice, with 50%\u2013100% recovery rates at follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Cardiovascular autonomic disorders may develop or worsen following a COVID\u201019 infection, whilst the association with COVID\u201019 vaccines remains controversial. Despite the severe pandemic impact on European clinical autonomic practice, a specialized diagnostic work\u2010up was pivotal to identify non\u2010autonomic disorders in people with post\u2010COVID\u201019 orthostatic complaints.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15787","type":"journal-article","created":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T14:14:33Z","timestamp":1678889673000},"page":"1712-1726","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Impact of the <scp>COVID<\/scp>\u201019 pandemic on clinical autonomic practice in Europe: a survey of the European Academy of Neurology and the European Federation of Autonomic Societies"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2854-4179","authenticated-orcid":false,"given":"Alessandra","family":"Fanciulli","sequence":"first","affiliation":[{"name":"Department of Neurology Medical University of Innsbruck  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