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Pandemic-induced surge in POTS cases: An overview of Postural Orthostatic Tachycardia Syndrome

Long-term COVID-19 survivors grapple with a disabling condition, and some claim that the prescribed treatment - regular exercise - has yielded negative consequences.

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Pandemic-related surge in POTS: An unusual condition that has seen a significant increase in cases...
Pandemic-related surge in POTS: An unusual condition that has seen a significant increase in cases since the onset of the pandemic

Pandemic-induced surge in POTS cases: An overview of Postural Orthostatic Tachycardia Syndrome

In the ongoing battle against the lasting effects of COVID-19, one condition that has been gaining attention is Postural Orthostatic Tachycardia Syndrome (POTS). This disorder, characterised by a spike in heart rate upon standing, affects millions worldwide, and its numbers have doubled since the pandemic began.

One prominent figure living with POTS is Oonagh Cousins, a member of Great Britain's rowing team. Cousins recommends medications such as beta-blockers, fludrocortisone, and midodrine for managing POTS, but these treatments come with potential side effects including fatigue, low blood pressure, and electrolyte imbalances.

POTS often co-exists with other health conditions, such as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). In fact, an estimated 79% of long COVID patients meet the criteria for POTS. For Lindsay Levinson, a long COVID patient who also has POTS and ME/CFS, resuming her spinning classes led to a massive relapse.

Exercise is considered a first-line treatment for POTS, but for many long COVID patients, this approach can be challenging. A study on the effect of exercise on POTS symptoms found that 89.5% of long COVID patients reported relapses after exertion. The study, however, excluded patients with other conditions often found in POTS patients, such as autoimmune disorders. The study also had a high drop-out rate, with only 103 of 251 enrolled participants completing the three-month Levine exercise protocol.

The National Institute of Health and Care Excellence cautions against using graded exercise therapy for treating post-COVID fatigue, a symptom commonly experienced by POTS patients. Pushing past physical limits in POTS recovery exercise protocols can lead to major crashes for patients with ME/CFS.

For Whitney Fox, who was diagnosed with ME/CFS and POTS in 2019, even small amounts of exercise pushed her into a cycle of over-exertion followed by crashes. Understanding new limits on exertion has been a steep learning curve for many POTS patients.

Despite the challenges, there are success stories. U.S. Olympic swimmer Katie Ledecky also lives with POTS. For Stiles, who was a competitive snowboarder before developing POTS, exercise did not relieve her symptoms. However, after she was diagnosed and treated for an autoimmune disorder, exercise became beneficial for her.

In the face of these complexities, it's clear that managing POTS and long COVID requires a nuanced approach, combining pharmaceutical and non-pharmaceutical treatments, and a deep understanding of each individual's unique health journey.

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