Clinical features of postural tachycardia syndrome after COVID-19 infection

Abstract

Orthostatic intolerance following coronavirus disease 2019 (COVID-19), characterized by lightheadedness and palpitations, can severely impair the quality of life of some patients. Postural orthostatic tachycardia syndrome (POTS) is recognized as one of the manifestations of long COVID although its frequency and pathogenesis are still largely unknown. In the present study, POTS (COVID-POTS) was diagnosed in eight (12%) of the patients who visited our outpatient clinic with long COVID. All the patients with COVID-POTS had severe fatigue, and four (50%) required a leave of absence from work. However, all the patients experienced spontaneous recovery after their symptoms peaked, with the shortest leave of absence being three months from COVID-19 onset. A comparison of their clinical features with those of 24 patients with chronic POTS unrelated to COVID-19 found that most chronic POTS patients had abdominal symptoms, such as irritable bowel syndrome, which were associated with POTS severity while none of the COVID-POTS patients had abdominal symptoms.