A MAJOR study has revealed that postural orthostatic tachycardia syndrome (POTS) is present in nearly one-third of patients with severe long COVID, particularly affecting middle-aged women. This high prevalence means POTS is now an important focus for screening and management in those still suffering persistent symptoms after COVID-19.
High Prevalence of POTS in Long COVID
Long COVID continues to challenge doctors, especially with the emergence of overlapping syndromes like POTS. The condition, marked by a rapid rise in heart rate upon standing, dizziness, fatigue, and concentration problems, was diagnosed in 31% of highly symptomatic long COVID patients studied. This is strikingly more common than the pre-pandemic population rate, previously less than one per cent. Long COVID patients with POTS, mainly younger women, showed worse physical ability and overall health compared to those without the syndrome.
Study Design and Results: Gender and Impact
Researchers at Karolinska Institutet examined 467 nonhospitalised long COVID patients, all of whom had severe symptoms leading to substantial sick leave. Physical tests, cardiac monitoring, and questionnaires revealed 91% of those diagnosed with POTS were women, mostly in early middle age. Heart rate data during walking and standing were notably higher for the POTS group. However, other individual symptoms like brain fog and fatigue were similarly distributed between those with and without POTS.
Clinical Implications and Next Steps for Long COVID
Encouragingly, POTS can be diagnosed with simple, inexpensive tests available in routine clinics, and effective therapies exist to reduce symptoms and improve life quality. The study’s authors advise screening all long COVID patients showing key symptoms, such as rising heart rate on standing, dizziness, and fatigue, for POTS to support recovery and better management. Ongoing research aims to track recovery over several years, including for those previously hospitalised for COVID-19.
Reference
Björnson M et al. Prevalence and clinical impact of postural orthostatic tachycardia syndrome in highly symptomatic long COVID. Circulation: Arrhythmia and Electrophysiology. 2025;e013629.
