Rate of postural orthostatic tachycardia syndrome increased after COVID-19 pandemic
Key takeaways:
- Baseline comorbidities did not significantly differ between pre- and post-pandemic cohorts.
- However, prevalence of autonomic nervous system disorders and related comorbidities decreased post-COVID.
After the COVID-19 pandemic, the incidence rate of postural orthostatic tachycardia syndrome increased significantly, according to new data published in the European Heart Journal – Quality of Care and Clinical Outcomes.
“Postural orthostatic tachycardia syndrome (POTS) is a chronic condition characterized by an abnormal increase in heart rate upon standing, often accompanied by symptoms such as dizziness, lightheadedness, fatigue and syncope,” Dharmindra Dulal, medical student at the University of Toledo College of Medicine and Life Sciences, and colleagues wrote. “Viral illnesses, including influenza, Epstein-Barr virus and, more recently, COVID-19, have been identified as potential triggers for the onset of POTS in previously healthy individuals. ... Given the increasing number of POTS cases reported after COVID-19, we sought to examine the baseline characteristics of POTS patients, as well as trends in the incidence and prevalence of POTS, both before and after the onset of the COVID-19 pandemic.”
Using data from the TriNetX database — a cohort of more than 65 million adult patients across 64 health care organizations — Dulal and colleagues analyze trends over time to assess changes in POTS rates before and after the pandemic.
Monthly data on incidence, cases and prevalence of POTS were collected from January 2018 to June 2024, with March 1, 2020, serving as the cutoff for pre- and post-pandemic eras.
The researchers identified 11,191 patients with POTS for the pre-pandemic cohort (mean age, 36 years; 86% women) and 51,601 (mean age, 35 years; 87% women) patients for the post-pandemic cohort.
There was no significant difference in comorbid conditions between the pre- and post-pandemic cohorts. However, the researchers noted the prevalence of autonomic nervous system disorders (18% vs. 15%), idiopathic peripheral autonomic neuropathy (3% vs. 1%), and epilepsy and recurrent seizures (7% vs. 6%) were higher (P < .001) in the pre-pandemic cohort compared with the post-pandemic cohort.
The researchers reported an increase in the incidence rate of POTS in the post-pandemic group (P < .0001), with the rate increasing from 1.42 per 1,000,000 person-years in the pre-pandemic group to 20.3 per 1,000,000 person-years in the post-pandemic group, according to the study.
Monthly incident cases of POTS showed a similar trend, with an average of 4.21 additional monthly cases in the pre-pandemic cohort to 22.66 cases in the post-pandemic cohort (P < .001), according to the study.
The month-to-month prevalence rate of POTS initially declined from 220.45 to 205.64 cases after the pandemic, but was followed by a robust increase starting in January 2023 to 504.77 (P < .001).
“This study demonstrates a significant increase in the incidence and prevalence of postural orthostatic tachycardia syndrome following the COVID-19 pandemic,” the researchers wrote. “Our analysis of a large cohort from the TriNetX database reveals that many patients with post-viral symptom may develop POTS, emphasizing the need for clinicians to screen for this condition in post-COVID patients. These findings highlight the importance of early identification and management of POTS to improve patient outcomes. Ongoing research is essential to explore the mechanisms linking COVID-19 to POTS and to assess the long-term implications of these trends in the context of evolving health care needs”
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