Prevalence and Clinical Impact of Postural Orthostatic Tachycardia Syndrome in Highly Symptomatic Long COVID
Björnson, Mikael ; Wijnbladh, Klara ; Törnberg, Anna ; Svensson-Raskh, Anna ; Svensson, Annie ; Ståhlberg, Marcus ; Runold, Michael ; Fedorowski, Artur LU
; Nygren Bonnier, Malin
and Bruchfeld, Judith
(2025)
In Circulation: Arrhythmia and Electrophysiology
- Abstract
BACKGROUND: The incidence of postural orthostatic tachycardia syndrome (POTS) in long COVID has been a growing concern since the first cases were reported in 2021. The aim of this study was to assess the prevalence and clinical impact of POTS in a series of well-characterized patients with long COVID.
METHODS: We prospectively analyzed 467 nonhospitalized, highly symptomatic (sick leave ≥50%) patients with long COVID, and studied differences in demographics and clinical assessment outcomes between those diagnosed with POTS and the remaining long COVID patients. Examinations were performed at a median of 12 months after acute COVID-19, followed by a cardiologist evaluation with 48-hour ECG, head-up tilt test, and Active Stand Test... (More)
BACKGROUND: The incidence of postural orthostatic tachycardia syndrome (POTS) in long COVID has been a growing concern since the first cases were reported in 2021. The aim of this study was to assess the prevalence and clinical impact of POTS in a series of well-characterized patients with long COVID.
METHODS: We prospectively analyzed 467 nonhospitalized, highly symptomatic (sick leave ≥50%) patients with long COVID, and studied differences in demographics and clinical assessment outcomes between those diagnosed with POTS and the remaining long COVID patients. Examinations were performed at a median of 12 months after acute COVID-19, followed by a cardiologist evaluation with 48-hour ECG, head-up tilt test, and Active Stand Test for those with clinically suspected POTS.
RESULTS: Of all long COVID patients, 143 (31%) were diagnosed with POTS, 128 (27%) did not fulfill POTS criteria, while 196 (42%) had no clinical signs of POTS. Patients with POTS were younger (mean age, 40.0 versus 44.0 versus 47.0 years, respectively;
P≤0.001) and predominantly female (91%). They had significantly lower physical activity compared with the other 2 groups, as measured with the Frändin-Grimby scale (
P=0.001). Heart rates during the 6-minute walk test were significantly higher in the POTS group, both during walking and at rest afterward, with a significantly shorter walking distance (448 m versus 472 m versus 509 m, respectively;
P≤0.001). However, the distribution of symptoms showed no significant differences between the groups.
CONCLUSIONS: In this cohort of predominantly younger women with highly symptomatic long COVID, POTS is common and presents with overlapping symptoms between POTS and non-POTS patients. Long COVID POTS confers lower physical activity and capacity compared with non-POTS long COVID and should be systematically assessed in this condition.
(Less)
- author
- Björnson, Mikael
; Wijnbladh, Klara
; Törnberg, Anna
; Svensson-Raskh, Anna
; Svensson, Annie
; Ståhlberg, Marcus
; Runold, Michael
; Fedorowski, Artur
LU
; Nygren Bonnier, Malin
and Bruchfeld, Judith
- publishing date
- 2025-09-30
- type
- Contribution to journal
- publication status
- epub
- in
- Circulation: Arrhythmia and Electrophysiology
- article number
- e013629
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- pmid:41025260
- ISSN
- 1941-3084
- DOI
- 10.1161/CIRCEP.124.013629
- language
- English
- LU publication?
- no
- id
- b6dccb78-d558-4a9c-a1f6-82c75f097b4a
- date added to LUP
- 2025-10-07 00:30:33
- date last changed
- 2025-10-07 07:52:12
@article{b6dccb78-d558-4a9c-a1f6-82c75f097b4a,
abstract = {{<p>BACKGROUND: The incidence of postural orthostatic tachycardia syndrome (POTS) in long COVID has been a growing concern since the first cases were reported in 2021. The aim of this study was to assess the prevalence and clinical impact of POTS in a series of well-characterized patients with long COVID.</p><p>METHODS: We prospectively analyzed 467 nonhospitalized, highly symptomatic (sick leave ≥50%) patients with long COVID, and studied differences in demographics and clinical assessment outcomes between those diagnosed with POTS and the remaining long COVID patients. Examinations were performed at a median of 12 months after acute COVID-19, followed by a cardiologist evaluation with 48-hour ECG, head-up tilt test, and Active Stand Test for those with clinically suspected POTS.</p><p>RESULTS: Of all long COVID patients, 143 (31%) were diagnosed with POTS, 128 (27%) did not fulfill POTS criteria, while 196 (42%) had no clinical signs of POTS. Patients with POTS were younger (mean age, 40.0 versus 44.0 versus 47.0 years, respectively; <br>
P≤0.001) and predominantly female (91%). They had significantly lower physical activity compared with the other 2 groups, as measured with the Frändin-Grimby scale (<br>
P=0.001). Heart rates during the 6-minute walk test were significantly higher in the POTS group, both during walking and at rest afterward, with a significantly shorter walking distance (448 m versus 472 m versus 509 m, respectively;<br>
P≤0.001). However, the distribution of symptoms showed no significant differences between the groups.<br>
</p><p>CONCLUSIONS: In this cohort of predominantly younger women with highly symptomatic long COVID, POTS is common and presents with overlapping symptoms between POTS and non-POTS patients. Long COVID POTS confers lower physical activity and capacity compared with non-POTS long COVID and should be systematically assessed in this condition.</p>}},
author = {{Björnson, Mikael and Wijnbladh, Klara and Törnberg, Anna and Svensson-Raskh, Anna and Svensson, Annie and Ståhlberg, Marcus and Runold, Michael and Fedorowski, Artur and Nygren Bonnier, Malin and Bruchfeld, Judith}},
issn = {{1941-3084}},
language = {{eng}},
month = {{09}},
publisher = {{Lippincott Williams & Wilkins}},
series = {{Circulation: Arrhythmia and Electrophysiology}},
title = {{Prevalence and Clinical Impact of Postural Orthostatic Tachycardia Syndrome in Highly Symptomatic Long COVID}},
url = {{http://dx.doi.org/10.1161/CIRCEP.124.013629}},
doi = {{10.1161/CIRCEP.124.013629}},
year = {{2025}},
}