What’s the link between COVID-19 and POTS?

More individuals with long Covid are found to be suffering from chest pains. Additionally, COVID-19 “long-haulers” are found to be suffering from a condition known as Postural Orthostatic Tachycardia Syndrome (POTS)^[1]. POTS is caused by malfunction of the involuntary nervous system, leading to abnormal heart rate and blood pressure when the body position changes from the horizontal to the standing position.

Patients may develop POTS after a variety of conditions including viral illness, serious infections, pregnancy and trauma. More data is suggesting that coronavirus can be a trigger for POTS. As symptoms of POTS can be non-specific, it may be difficult to diagnose at times. However, because POTS can be very debilitating and requires specific treatment, an accurate diagnosis is necessary.

What are the symptoms like?

POTS symptoms can be uncomfortable and frightening. The patient usually suffers from 2 or more of the following symptoms:

• Severe and/or long-lasting fatigue
• Lightheadedness with prolonged sitting and standing
• Brain fog with trouble focusing, remembering or paying attention
• Forceful or racing heartbeat
• Chest pain
• Headaches and body pain/aches
• Nausea and vomiting
• Shakiness/tremors, especially with adrenaline surges

How do doctors diagnose post-COVID POTS?

You should talk to your doctor if you have had COVID-19 and are experiencing some of the above symptoms. POTS can be difficult to diagnose due to so many symptoms involving many different organ systems. At the moment, doctors do not know all the possible effects of long-haul COVID-19. Hence in order to make a diagnosis, other causes will need to be ruled out first^[2].

What is the treatment for post-COVID POTS?

As for acute management, if you feel lightheaded, sit or lie down right away. When you feel well enough to get up, do it slowly and carefully to allow your body to adjust^[3].

Long term treatment will depend on the nature of your symptoms, age, and general health. Some general advice may include:

• Drink plenty of water
• Get more salt in your diet
• Use compression stockings to keep fluid from pooling in your legs

Pharmacological treatment may be prescribed as well such as anti-hypertensive, antidepressants, supplemental vitamins, and oral analgesics.

Once you respond to treatment sufficiently, you may be referred to undergo a physical therapy regimen.

Mental health is just as important when dealing with POTS. Your doctor may refer you to a counsellor to help you cope with this chronic health condition.

Reference

1. Raj, S. R., Arnold, A. C., Barboi, A., Claydon, V. E., Limberg, J. K., Lucci, V.-E. M., Numan, M., Peltier, A., Snapper, H., Vernino, S., & American Autonomic Society. (2021, June). Long-Covid Postural Tachycardia Syndrome: An American Autonomic Society Statement. Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society. Retrieved October 5, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7976723/.

2. Dani, M., Dirksen, A., Taraborrelli, P., Torocastro, M., Panagopoulos, D., Sutton, R., & Lim, P. B. (2021, January). Autonomic dysfunction in 'long COVID': rationale, physiology and management strategies. Clinical medicine (London, England). Retrieved October 5, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7850225/.

3. GrubbMD, B. P., Grubb, B. P., Blair P. Grubb From the Cardiology Department of Medicine, & Grubb, C. to B. P. (2005, June 7). Neurocardiogenic Syncope and Related Disorders of Orthostatic Intolerance. Circulation. Retrieved October 5, 2021, from https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.104.482018?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%2B%2B0pubmed&.