Post-acute sequelae of SARS-CoV-2 (PASC) syndrome presenting as postural orthostatic tachycardia syndrome (POTS)

Diekman, Sarah; Chung, Tae

doi:.0..

Clin Exp Emerg Med > Accepted Articles

Review Article

doi: https://doi.org/10.15441/ceem.22.409 [Accepted]

Post-acute sequelae of SARS-CoV-2 (PASC) syndrome presenting as postural orthostatic tachycardia syndrome (POTS)

Sarah Diekman^1,2, Tae Chung³

¹Diekman Dysautonomia LLC., Oakland, MD, USA
²Department of Epidemiology, University of North Carolina Gillings School of Public Health, Chapel Hill, NC, USA
³Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD, USA

Correspondence Tae Chung Email: tchung7@jhmi.edu

Received: December 8, 2022. Revised: December 29, 2022. Accepted: December 29, 2022. Published online: January 30, 2023.

ABSTRACT

The novel SARS-CoV-2 emerged in 2019, and the global COVID-19 pandemic continues into 2022. It has been known that a subset of patients develops chronic, debilitating symptoms after otherwise complete recovery from acute infection of COVID-19. Multiple terms have been used to describe this constellation of symptoms, including long COVID, long-haul COVID, and post-acute sequelae of SARS-CoV-2 syndrome (PASC). PASC is broadly defined as a wide range of new, returning, or ongoing symptoms at least four weeks after infection. Those patients are often seen in emergency departments after acute COVID- 19 infection, but their symptoms are not adequately managed because the underlying pathophysiology of PASC is not well understood. Among patients with PASC, postural orthostatic tachycardic syndrome (POTS) has been increasingly recognized. POTS is one of the most common forms of autonomic dysfunction and defined by a sustained orthostatic tachycardia during active standing or head-up tilt test in the absence of orthostatic hypotension or other cardiopulmonary diseases. Because POTS is a treatable condition, it is important to recognize POTS among PASC patients. Herein, we reviewed the current literature on POTS and dysautonomia in PASC in order to better understand the overlap and distinction between these pathologies.

Keywords: PASC, POTS, post COVID syndrome, postural tachycardia syndrome, long haul COVID