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Review
. 2023 Mar 31;15(3):e36955.
doi: 10.7759/cureus.36955. eCollection 2023 Mar.

COVID-19 Induced Postural Orthostatic Tachycardia Syndrome (POTS): A Review

Deobrat Mallick  1 , Lokesh Goyal  2 , Prabal Chourasia  3 , Miana R Zapata  4 , Kanica Yashi  5 , Salim Surani  6   7   8   9   10
Affiliations
Review

COVID-19 Induced Postural Orthostatic Tachycardia Syndrome (POTS): A Review

Deobrat Mallick et al. Cureus. .

Abstract

POTS (Postural Orthostatic Tachycardia Syndrome) is a multisystem disorder characterized by the abnormal autonomic response to an upright posture, causing orthostatic intolerance and excessive tachycardia without hypotension. Recent reports suggest that a significant percentage of COVID-19 survivors develop POTS within 6 to 8 months of infection. Prominent symptoms of POTS include fatigue, orthostatic intolerance, tachycardia, and cognitive impairment. The exact mechanisms of post-COVID-19 POTS are unclear. Still, different hypotheses have been given, including autoantibody production against autonomic nerve fibers, direct toxic effects of SARS-CoV-2, or sympathetic nervous system stimulation secondary to infection. Physicians should have a high suspicion of POTS in COVID-19 survival when presented with symptoms of autonomic dysfunction and should conduct diagnostic tests like the Tilt table and others to confirm it. The management of COVID-19-related POTS requires a comprehensive approach. Most patients respond to initial non-pharmacological options, but when the symptoms become more severe and they do not respond to the non-pharmacological approach, pharmacological options are considered. We have limited understanding and knowledge of post-COVID-19 POTS, and further research is warranted to improve our understanding and formulate a better management plan.

Keywords: covid-19; covid-19 vaccine; postural orthostatic tachycardia syndrome; pots; sars-cov-2.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Possible mechanisms of COVID-induced POTS
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