A significant new study has found that the majority of patients with long-term COVID, also known as post-acute sequelae of COVID-19 (PASC), meet the diagnostic criteria for postural orthostatic tachycardia syndrome (POTS). The study, published in The American Journal of Medicine, revealed that 79% of PASC participants met the internationally established criteria for POTS.
The research involved 99 participants aged 18 years and older with PASC and POTS, who were receiving treatment at a specialist cardiology clinic. The participants underwent comprehensive self-testing, which included hemodynamic monitoring, assessments of respiratory sinus arrhythmia, Valsalva’s ratio, orthostatic changes, and sudomotor functioning. The study also employed the use of the Composite Autonomic Symptom Score (COMPASS-31) and the Euroquol 5-Dimensional Survey (EQ-5D-5L) to evaluate symptoms and measures of quality of life related to health.
POTS is characterized by orthostatic intolerance (OI) as its primary symptom, with dizziness or fainting being the main complaint. It is more commonly observed in women between the ages of 15 and 50, and its exact cause remains unknown.
Notably, a previous study published in Nature Cardiovascular Research suggested an increased incidence of POTS in individuals who were vaccinated against COVID-19 or had previously contracted the virus. The study found that the risk of POTS was higher 90 days after vaccine exposure compared to the preceding 90 days, and the odds of POTS were higher following SARS-CoV-2 infection compared to conventional primary care diagnoses.
The authors of the current study believe that there may be a connection between long COVID and POTS, citing the high prevalence of autonomic symptomatology or POTS in individuals with PASC. They emphasize the pressing need for healthcare providers, health services, and governments to prioritize the care of those affected due to the significant impact of PASC on health-related quality of life.
Interestingly, the majority of participants in the study reported experiencing mild acute COVID-19 infection, and there was a delay of at least two weeks between the onset of autonomic symptoms and the acute infection. This observation further supports the hypothesis that COVID-19 may act as a trigger for dysautonomia, the dysfunction of the autonomic nervous system.
In conclusion, this study adds empirical evidence to the link between POTS and long COVID. The findings highlight the need for increased attention and improved care for individuals with PASC, considering the substantial impact of POTS on their health and well-being. The research also provides insight into the role of COVID-19 as a possible trigger for dysautonomia. As more studies are conducted, it is hoped that further understanding will be gained, leading to better management and treatment options for those affected by POTS and long-term COVID.
