Is Postural Orthostatic Tachycardia Syndrome a Prevalent in COVID-19 Survivors?

According to a story from Healio, a speaker at the Heart in Diabetes CME Conference claimed that postural orthostatic tachycardia syndrome (POTS) is becoming a common complication for long COVID-19 survivors. The speaker in question was Pam R. Taub, MD, FACC, who is the director and founder of the Step Family Cardiac Rehabilitation and Wellness Center. She is also a medical professor at the UC San Diego Health System. 

About Postural Orthostatic Tachycardia Syndrome

Postural orthostatic tachycardia syndrome (POTS) is a condition that is characterized by an abrupt increase in heart rate when the patient changes from a lying position to a standing one. The cause of POTS is not well understood in all cases and can vary considerably. In some cases, it can appear as a complication related to another illness. About 50% of cases of POTS are associated with a recent viral infection. Other risks include low blood volume, chronic fatigue syndrome, and deconditioning during recovery from another illness. Symptoms include fatigue, sleep problems, fainting, acrocyanosis, blurred vision, cognitive problems, palpitations, light-headedness, and headaches. Treatment involves a variety of medications (used off label), and lifestyle changes such as staying hydrated, increased salt intake, avoiding alcohol, caffeine, and prolonged exercise, and eating food in small portions. To learn more about POTS, click here.

The Pandemic’s Impact

Dr. Taub notes that the COVID-19 pandemic heralded a massive increase in the number of POTS cases. While the cause of the condition isn’t clear, it’s associated with a genetic predisposition, and COVID-19 infection appears to trigger “immunologic derangement” in this population.

She also noted in her presentation that treatment for POTS should account for the potential autoimmune abnormalities that were revealed by COVID. 

“We really need to take orthostatic vitals on all of our patients that are having these symptoms of tachycardia, chest pain or dyspnea. It’s really important to identify these patients early, and once we treat them early, we prevent the evolution into chronic fatigue.” – Dr. Taub

Other theories regarding the development of POTS in COVID survivors include persistence of the virus in fat cells and the presence of autoantibodies following infection. Continued research into the relationship between POTS and COVID-19 is ongoing. 

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