Long Covid or POTS?

Let’s talk about long covid a minute.

I know.  You’re ready to move past the topic of COVID19.  Believe me, I am too.  The fact remains that COVID is still causing a ruckus.  

There have been reports of an increased number of referrals for POTS in autonomic clinics in the United States, Canada, and United Kingdom since the start of the COVID-19 pandemic.  Why?  Because POTS is sometimes triggered in a person’s body as a response to viral infections.  

WHAT CAUSED MY POTS?

The question of what caused POTS symptoms to be triggered in a person’s body is still largely unknown.  However, we do know that viral events can be to blame.  The simple cold virus could trigger POTS.  

Other things can trigger POTS too.  Things such as traumatic events; car crashes, broken bones, surgery, etc.  Pregnancy can trigger POTS.  Psychological events such as grief can trigger POTS (breakups count as grief too).  Some studies have suggested that vaccinations can also be to blame.  Researchers are studying to see if it could be an autoimmune response.

The quick and easy response here is: we don’t know what causes POTS, but the silver lining is that it’s being researched.  Hopefully over time we will know more.

LONG COVID

According to federal government estimates released in 2022, nearly 1 in 5 adults who have had COVID-19 in the past were still experiencing at least one symptom of long COVID – fatigue, shortness of breath, brain fog, chest pain and headaches among others

A global survey of almost 4000 COVID survivors found that the 30% of patients who developed chronic tachycardia after infection reported experiencing a heart rate increase of  30 beats or more a minute when standing.  That’s interesting because one of the ways POTS is diagnosed is through what is called Tilt Table Test.  During that test, you will be strapped to a table going from a horizontal to a vertical position while having your vitals monitored.  Some physician’s also perform a more informal test called the Poor Man’s Tilt Table Test (which you can do yourself at home too).

In general, during those tests if your heart rate increases over 30 beats or more per minute then it’s possible you will find yourself with a new diagnosis of POTS.

SO, IT’S NOT LONG COVID?

The fact remains that the jury is out on this one.

Studied findings are pointing to POTS as a potential diagnosis for people who were originally diagnosed with long COVID.

A meta-analysis of almost 50,000 COVID survivors aged 17–87 years, found that 80% of patients experience what we call “long covid”.  Among these patients

• 58% report fatigue
• 44% headaches
• 27% brain fog 
• 24% dyspnea
• 11% tachycardia
• 10% decreased exercise tolerance

All that sounds like what?!  POTS!  Yes.  

That said, our knowledge of the mechanisms behind post–COVID POTS is still evolving.  Research suggests that 67% of Long COVID patients are developing moderate to severe dysautonomia, most often presenting as POTS.

If you suspect that you may have POTS, please speak to your doctor.  It can take an average of 7 years to get a diagnosis, but if you advocate for yourself and bring your findings to your physician you’ll have a better chance of getting an answer sooner.