PoTS and Long Covid

December 6, 2021

PoTS and long Covid including information for people with ME/CFS

Dr Charles Shepherd, Honorary Medical for the ME Association comments on the following paper; Autonomic dysfunction post-acute COVID-19 infection (Desai et al, Nov 2021)

This new paper from an American research group provides further evidence of dysfunction of the autonomic nervous system (ANS) in Long Covid – in particular, the presence of Postural Orthostatic Tachycardia Syndrome (PoTS) in a significant proportion of people with Long Covid

Much of the information on management is also applicable to PoTS where it occurs in ME/CFS

ANS dysfunction is very common in ME/CFS and we have been pointing out the important overlap involving this symptom between ME/CFS and Long Covid for well over a year.

The MEA information leaflet on PoTS covers all aspects of PoTS in relation to ME/CFS:

Postural Orthostatic Tachycardia Syndrome (PoTS)

PoTS UK is a medical charity that can provide more detailed information and has a list of NHS specialists:

Dr Shepherd continues:

“One interesting observation in this paper relates to the possibility that improvements that have been reported by people with Long Covid after receiving a Covid-19 vaccination might be due to elimination of residual viral particles in the tissues

Beyond receipt of medication, of six patients receiving the COVID-19 vaccine, three patients noticed improved symptoms and three symptoms noticed unchanged symptoms. Importantly, none of these patients experienced worsening of symptoms, a complication which was originally suspected and feared for patients both with long COVID and previous COVID-infection during initial vaccine rollout.

This small cohort suggests the feasibility of vaccination in the population of patients suffering from suspected post-COVID AD, with no specific worsening of symptoms noted. A study of 6,030 individuals in the UK revealed the odds of long COVID symptoms, including autonomic dysfunction, were nearly halved when receiving both doses of the SARS-CoV-2 vaccine, supporting our findings.

While the exact mechanism for why these symptoms are alleviated following immunisation remain unclear, among many hypotheses, one which may be likely is that residual viral particles in tissues may be eliminated following administration of the vaccine, helping to alleviate lingering symptoms for the subset of patients who experience them. Further longitudinal studies comparing vaccinated individuals to those unwilling to take the vaccine should be conducted to evaluate the efficacy of these vaccines to resolve longer-term symptoms of COVID-19, including autonomic dysfunction, in a larger and more controlled setting.”

Dr Charles Shepherd,
Trustee and
Hon. Medical Adviser
to the ME Association.
Member of the 2018-2021 NICE Guideline Committee.
Member of the 2002 Independent Working Group on ME/CFS.

Dr Charles Shepherd
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