Though the COVID-19 pandemic is more or less in our collective rearview mirror, not everyone is living carefree. Unfortunately for some, their COVID infections triggered something else: Postural orthostatic tachycardia syndrome, aka POTS. This syndrome has affected their daily lives for the better part of the last two years without much end in sight.
What is POTS, and Why Has This Strange Disorder Doubled Since the Pandemic?
Postural orthostatic tachycardia syndrome (POTS) is a relatively uncommon but debilitating disorder that affects the autonomic nervous system. It is characterized by an abnormal increase in heart rate upon standing, resulting in symptoms such as dizziness, fatigue, fainting, and gastrointestinal issues. While POTS has been known for quite some time, its prevalence has significantly increased since the onset of the COVID-19 pandemic. Let’s explore the basics of POTS and examine the reasons behind the dramatic surge in cases during the pandemic. (1)
Understanding POTS
POTS primarily affects young individuals, particularly women of childbearing age. It is estimated that between one and three million Americans suffer from this disorder, but the numbers could be even higher due to the lack of awareness and proper diagnosis. Although several theories have been proposed, the underlying cause of POTS remains elusive.
The hallmark symptom of POTS is a rapid heart rate when changing from lying to standing. This abnormal response can lead to insufficient blood flow to the brain, resulting in lightheadedness, dizziness, and even fainting. Other common symptoms of POTS include fatigue, brain fog, chest pain, gastrointestinal issues, and disturbances in sleep patterns. Diagnosing POTS can be challenging as its symptoms often overlap with other conditions. A tilt-table test, in which the patient is tilted upright on a table while their heart rate and blood pressure are monitored, is commonly used to confirm the diagnosis.
POTS and the Pandemic
Since the outbreak of the COVID-19 pandemic, there has been a noticeable increase in POTS cases worldwide. This is specifically for those who only suffered from mild COVID symptoms. While the precise reasons for this surge are still under investigation, several factors may contribute to the correlation. (2, 3)
- Post-Infectious Effects: COVID-19 is known to cause a wide range of symptoms, some of which may persist long after the initial infection. Many individuals who have recovered from COVID-19 report symptoms similar to POTS, such as heart palpitations, fatigue, and exercise intolerance. It is possible that the virus triggers an immune response that affects the autonomic nervous system, leading to POTS-like symptoms.
- Psychological Stress: The pandemic has brought about unprecedented psychological stressors such as fear, anxiety, and social isolation. Psychological stress has been found to worsen POTS symptoms and trigger flare-ups. The combination of the ongoing pandemic-related stress and the pre-existing vulnerability of individuals with POTS may contribute to the increase in cases.
- Sedentary Lifestyle: Lockdowns, stay-at-home orders, and work-from-home setups have resulted in a more sedentary lifestyle for many individuals. Lack of physical activity and prolonged periods of sitting can exacerbate POTS symptoms. Reduced blood flow due to immobility can lead to blood pooling in the lower extremities, thus intensifying the already compromised autonomic system in POTS patients.
- Delays in Diagnosis and Treatment: The pandemic has disrupted medical services and caused delays in diagnoses and treatments for various conditions. Many individuals with POTS may have experienced difficulties in accessing specialized care, leading to delayed identification and management of their symptoms.
The Importance of Raising Awareness
The surge in POTS cases during the pandemic underscores the importance of raising awareness about this disorder. Increased recognition and understanding can lead to earlier diagnosis, appropriate medical intervention, and improved quality of life for individuals living with POTS.
Furthermore, it is essential for healthcare professionals to be knowledgeable about the potential post-infectious effects of COVID-19, including the development of POTS-like symptoms. Early identification and effective management can help prevent long-term complications and provide individuals with the support they need.
The Bottom Line
Postural orthostatic tachycardia syndrome (POTS) is a complex autonomic disorder that has significantly increased cases since the onset of the COVID-19 pandemic. Although the exact reasons behind this surge are still being studied, it is likely a combination of post-infectious effects, psychological stress, sedentary lifestyles, and delays in diagnosis and treatment.
Raising awareness about POTS and its potential relationship with the pandemic is crucial for early identification, appropriate management, and improved patient outcomes. As researchers continue to investigate the connection between POTS and the pandemic, a comprehensive understanding of this syndrome will empower healthcare professionals to provide better care and support for those affected.
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Sources
- “What is P O T S? This strange disorder has doubled since the pandemic.” National Geographic. Rachel Fairbank. October 2, 2023.
- “COVID-19 Induced Postural Orthostatic Tachycardia Syndrome (POTS): A Review.” NCBI. Deobrat Mallick, et al. March 2023.
- “Mild COVID-19 Linked to Postural Orthostatic Tachycardia Syndrome.” Cleveland Clinic