Insights into postural orthostatic tachycardia syndrome after COVID-19 in pediatric patients

Excerpt

The pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) profoundly threatened human health globally and greatly impacted the world economy [1]. While most patients recovered, some suffered from chronic symptoms after the acute phase of coronavirus disease 2019 (COVID-19). The typical clinical symptoms include fatigue, exercise intolerance, dyspnea, fogginess, dizziness, headache, and tachycardia/palpitations, which are termed “post-acute COVID-19 syndrome”, “post-acute sequelae of COVID-19 (PASC)”, and “long-haul COVID” [2]. The World Health Organization defined this condition as the occurrence of symptoms in individuals with a probable or confirmed history of SARS-CoV-2 infection, typically starting three months from the onset of COVID-19, persisting for at least two months, which is not attributable to any alternative diagnosis [3]. If these symptoms coincide with abnormal tachycardia upon standing and fulfill the diagnostic criteria for postural orthostatic tachycardia syndrome (POTS), they are referred to as “long-COVID POTS” [4]. To diagnose pediatric POTS, there must be a sustained increase in heart rate (HR) by 40 beats per minute (bpm) or greater within the first ten minutes of transitioning from a lying to a standing position without the occurrence of orthostatic hypotension, and no other possible causes identified [5]. …