Postural Orthostatic Tachycardia Syndrome in COVID-19: A Contemporary Review of Mechanisms, Clinical Course and Management

Bharat Narasimhan,1 Arundhati Calambur,2 Errol Moras,3 Lingling Wu,4 Wilbert Aronow5 1Department of Cardiology, Debakey Cardiovascular Institute, Houston Methodist, Houston, TX, USA; 2University of California San Diego, La Jolla, CA, USA; 3Department of Medicine, Icahn School of Medicine; Mount Sinai, New York, NY, USA; 4Department of Medicine, East Carolina University, Greenvile, NC, USA; 5Department of Cardiology, Westchester Medical Center, Valhalla, NY, USACorrespondence: Wilbert Aronow, Department of Cardiology, Westchester Medical Center, New York Medical College, 100 Woods Road, Macy Pavilion, Room 141, Valhalla, NY, 10595, USA, Email wsaronow@aol.comAbstract: The long-term implications of COVID-19 have garnered increasing interest in recent months, with Long-COVID impacting over 65 million individuals worldwide. Postural orthostatic tachycardia syndrome (POTS) has emerged as an important component of the Long-COVID umbrella, estimated to affect between 2 and 14% of survivors. POTS remains very challenging to diagnose and manage – this review aims to provide a brief overview of POTS as a whole and goes on to summarize the available literature pertaining to POTS in the setting of COVID-19. We provide a review of available clinical reports, outline proposed pathophysiological mechanisms and end with a brief note on management considerations.Keywords: POTS, COVID-19, long COVID, review