Impact of COVID-19 Pandemic on the incidence and prevalence of postural orthostatic tachycardia syndrome 2025 Maraey et al

Abstract

Background
Individuals recovering from COVID-19 infection have reported experiencing symptoms of postural orthostatic tachycardia syndrome (POTS). These observations have raised concerns about COVID-19 as a significant precipitating factor in the development of post-viral POTS. Given the increasing number of POTS cases reported after COVID-19, we sought to examine the baseline characteristics of POTS patients before and after COVID-19.

Methods
We conducted an interrupted time series analysis on data obtained from the TriNetX database, which included a cohort of 65 141 065 patients aged 18 and older across 64 healthcare organizations. Monthly data on incidence rates (IR), incidence cases (IC), and prevalence cases (PC) of POTS were collected from January 2018 to June 2024, with March 1, 2020, defined as the cutoff date for pre- and post-COVID analysis.

Results
There was a significant increase in the IR of POTS post-COVID (p < 0.0001), with the IR increasing from 1.42/1000 000 to 20.3/1000 000 cases per person-year. Similarly, the monthly IC trend showed a significant rise from 4.21 to 22.66 cases (p < 0.001). The month-to-month prevalence showed an initial decline after COVID with a robust increase starting January 2023. Additionally, the prevalence of autonomic nervous system disorders and related comorbidities significantly decreased in the post-COVID cohort.

Conclusion
Our findings demonstrate a significant increase in the incidence of POTS following the COVID-19 pandemic, suggesting a potential association between COVID-19 infection and the development of post-viral POTS. Future research should explore the underlying mechanisms and treatment strategies for POTS in the context of post-COVID recovery.

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