According to the most recent data from the Centers for Disease Control and Prevention, 1 in 13 adults in the United States suffer from COVID (CDC). And many individuals with chronic COVID develop postural orthostatic tachycardia syndrome, or POTS.
The medical term “long COVID” is used to describe problems that persist for at least 12 weeks after a SARS-COV-2 infection.
POTS is a kind of dysautonomia, which is the interruption of fundamental body functions such as heartbeat and breathing.
When changing body posture, POTS symptoms become most apparent. Following prolonged sitting or standing, you may experience:
Given how common SARS-COV-2 has grown, more people than ever before are acquiring POTS.
POTS can have a significant impact on your quality of life, but knowing the symptoms will help you receive the proper diagnosis and treatment.
Long COVID is more prevalent in adults, and women have a 22% higher risk of developing it. The gender distribution of POTS cases is even more lopsided, with four out of five cases affecting women aged 15 to 50. Nevertheless, both illnesses can affect individuals of any age or gender.
Can chronic COVID cause POTS?
Up to one in seven individuals with chronic COVID develop POTS.
And contrary to popular assumption, a severe COVID-19 infection is not necessary to induce long-term problems. In a research conducted at the Cleveland Clinic, 38 of 39 POTS patients had a mild form of COVID-19. COVID-19 infections, even asymptomatic ones, can induce POTS.
Obviously, POTS is not exclusive to lengthy COVID. It is the most prevalent form of dysautonomia in the United States, affecting between one and three million people.
“Even before COVID, the majority of POTS patients were infected with a virus or bacteria and got POTS as a result. We did not refer to this pathogen as Long EBV, Long Influenza, or Long Mycoplasma. We simply referred to it as POTS if a patient matched the POTS criteria “Lauren Stiles, assistant professor of neurology at Stony Brook University and president of Dysautonomia International, explains.
Does POTS increase the risk of chronic COVID?
Insufficient study has been conducted to determine whether preexisting POTS increases the likelihood of developing long-term COVID.
Having any respiratory ailment before to infection increases the chance of long-term COVID by 43%. And because more than 65 percent of persons with POTS experience breathing difficulties, the illness may raise the risk of COVID.
Moreover, a COVID-19 infection can temporarily increase your POTS symptoms. You may feel more fatigued or dizzy than usual during the duration of the infection and for several weeks following. However, this symptomatic worsening is typically transient; it is not the same as chronic COVID.
Was COVID-19 the cause of my POTS?
It can be difficult to determine whether your POTS symptoms are due to COVID-19, another illness, or a completely unrelated condition.
Long COVID is frequently difficult to diagnose for two primary reasons:
Your symptoms may manifest months following the first infection.
Officially, no laboratory test can diagnose lengthy COVID.
In general, however, if you get POTS symptoms after a COVID-19 infection and they cannot be explained by another illness, they are likely caused by long-term COVID.
When COVID-19 induces POTS, your symptoms may vary slightly from the typical profile of POTS symptoms. You are:
More prone to experience chronically elevated adrenaline levels that leave you feeling “on edge.”
More prone to suffer sleep troubles
Less prone to experience nerve injury, which can cause tingling or numbness in the hands and feet.
4. What are the symptoms of POTS caused by COVID?
Long-term COVID and POTS symptoms can vary considerably across individuals.
Your symptoms may be mildly bothersome, or they may severely impair your ability to function in daily life. In addition, the severity of symptoms can fluctuate according on your activity level.
People with COVID-related POTS who overexert themselves may have a post-exertional crash, also known as a “push crash,” according to Sunjya Schweig, MD, Founder and President of the California Center for Functional Medicine.
According to Schweig, a push crash might linger for hours, days, or even longer.
Note that this symptom flare, also known as post-exercise malaise, can occur with COVID even if you do not have POTS.
“It is difficult for many to foresee what degree of participation is achievable,” adds Schweig.
One day, a stroll to the mailbox may feel quite manageable. The next day, though, that same walk could leave you fatigued for an hour later. These fluctuating symptoms might significantly impair your professional and financial wellbeing.
Long-term COVID and POTS may have a major impact on your capacity to work, according to the evidence:
According to a study published in Lancet, 46% of patients with lengthy COVID needed to lower their work hours in order to continue working.
A survey by Dysautonomia International indicated that 72 percent of people with POTS need occupational changes, such as a reduction in hours, to continue working.
While it is too soon for experts to estimate the length of time needed to recover from COVID-related POTS, research on POTS indicates that 80% of persons eventually experience functional improvement. There may be lingering symptoms, but treatment can enhance your quality of life.
5. What are the potential causes of POTS associated with COVID?
Experts do not yet understand why so many COVID patients develop POTS.
According to one idea, the SARS-COV-2 virus directly harms the cardiovascular system. It has been demonstrated that the virus damages ACE2 proteins, which your body needs to regulate blood pressure.
A second theory centers on inflammation. Numerous individuals with COVID-related POTS have inflammatory diseases such as:
The virus may increase your body’s already high levels of inflammation to abnormal levels, resulting in “hyperactive” nerves. This may explain why POTS affects the entire body and not just the circulatory system.
Why is POTS frequently misidentified as anxiety?
POTS, particularly POTS associated with COVID, may induce a hyperactive fight-or-flight response. In fact, many individuals with this illness are initially diagnosed with an anxiety disorder, as symptoms such as a rapid heartbeat and shortness of breath can mimic panic attacks.
However, prior data from 2008 indicates that persons with POTS had similar prevalence of anxiety disorders as the general population.
People with long-lasting COVID and POTS are typically misdiagnosed with health worry rather than a medical problem. Therefore, it may take longer for them to receive the correct diagnosis and treatment. According to pre-pandemic data, persons with POTS wait an average of two years for treatment.
What does the treatment entail?
If you observe symptoms of extended COVID or POTS, you should contact a healthcare expert immediately.
To diagnose POTS, your physician will likely recommend the tilt table test. For this examination, you will be secured to a table that may rotate from horizontal to vertical. Within the first 10 minutes of standing, if your heart rate climbs by 30 beats per minute, you may have POTS.
“Research is continuing to create more focused treatments, but long COVID POTS is being treated in the same manner as short COVID POTS,” explains Stiles.
Here are the three primary therapy options for POTS:
1. non-pharmaceutical therapies
Typically, non-drug therapies are the initial line of treatment. Current POTS recommendations recommend:
These socks exert pressure to your legs to prevent blood from pooling in your feet when you stand.
These motions can increase your blood pressure and prevent fainting. Crossing your legs and tensing the muscles in them is a common example.
Avoiding excessive physical activity: Any prolonged exertion might result in a push-crash, even if the activity is not typically considered “intense.” When necessary, pay attention to your body and do not hesitate to take rests.
Levine protocol: This type of physical therapy consists of gentle, horizontal or seated activities.
One exercise that may be performed at home is the straight leg raise. Lying on your side, your lower leg should be slightly bent and your upper leg should be straight. Slowly raise your top leg 8-12 inches, then lower it. You can increase the difficulty by wrapping an elastic training band around your thighs for resistance.
2. Prescriptions
According to Stiles, the majority of persons with POTS additionally require one or more of the following medications:
To slow down a rapid heart rate, beta blockers or ivabradine may be used.
Vasoconstrictor midodrine constricts blood vessels.
The hormone fludrocortisone increases blood volume.
Pyridostigmine, which is known to decrease inflammatory markers that are high in POTS.
Important: Consult your physician before adding vitamins or supplements to your regimen, as they may interact with prescription drugs.
3. Support groups
Communities with chronic disease Surviving individuals have a long history of sharing information and resources.
Additionally, many individuals find the emotional support and affirmation they receive in these groups to be very healing.
If you have COVID-related POTS, you may find the following resources useful:
Body Politic advertises itself as a queer feminist wellness collective, and it offers a support group for those with long-term COVID illnesses, including POTS.
Dysautonomia International: This organization has support groups in each and every state and country. POTS Pals is one of the few support organizations for children under 13 years old with POTS.
This non-profit organization offers four regional support communities in the United States. Anyone with dysautonomia is welcome to join.
Standing Up to POTS: This organization is only for those with POTS. There is one group for adolescents and one for adults.
Insider’s takeaway
Long-term COVID may contribute to POTS, a disorder in which the body has difficulty controlling its own heart rate and blood pressure when the posture changes. POTS can induce a number of symptoms, including fainting and exhaustion, and can significantly impair daily functioning.
Because lengthy COVID is a relatively novel phenomena, researchers still have much to learn about COVID-related POTS, particularly the prognosis for this syndrome in the long term.
Existing treatments can significantly improve your general health and quality of life, despite the current limitations in research. A healthcare practitioner can provide further direction and assist you in evaluating your treatment options.