POTSPOTS and Long COVID: What the Research Shows
How often POTS appears after COVID-19, what studies of long COVID patients found, how infection compares with vaccination, and what is still uncertain.
Doctors began seeing more POTS after the COVID-19 pandemic started. The studies support a real link, with large uncertainty about its size.
What the studies found
- POTS (36%)
- Other orthostatic intolerance (71% in all)
21 studies of people tested in clinics because of symptoms, with signs of publication bias. Treat 36% as an upper estimate.
NEW POTS DIAGNOSES PER MILLION PERSON-YEARS
About 14 times more new diagnoses, across 65 million adults.
Symptoms in the Swedish cohort overlapped heavily with long COVID patients who did not meet POTS criteria.
Recovery
15%
POTS after COVID
43%
Other post-COVID autonomic problems
Infection versus vaccination
A 2024 systematic review of ten mostly case-report studies found post-COVID POTS risk about five times higher after infection than after vaccination, in the one cohort that compared them. The evidence is thin.
What this means for you
- If your heart rate on standing changed after a COVID infection, run a stand test and bring the numbers to your doctor.
- Post-COVID POTS uses the same criteria and the same first-line measures as other POTS. Dedicated trials are underway. See recent research.
- Pace yourself. Pushing hard through fatigue sometimes sets people back, so plan a gradual increase with your clinician.
What remains unknown
Researchers do not yet know whether post-COVID POTS follows the same course as other POTS, why some people develop it, or which treatments work best for this group. Most evidence is observational and low certainty.
This page informs and does not diagnose. Only a clinician who can examine you and see your whole history can interpret your numbers.
- Wang C, Fan Y, Li C, et al. The prevalence of orthostatic intolerance, postural orthostatic tachycardia syndrome and orthostatic hypotension in post-acute sequelae of COVID-19. Front Cardiovasc Med. 2025;12:1679252
- Bjornson M, Wijnbladh K, Tornberg U, Svensson-Raskh A, et al. Prevalence and clinical impact of postural orthostatic tachycardia syndrome in highly symptomatic long COVID. Circ Arrhythm Electrophysiol. 2025;18:e013629
- Dulal D, Maraey A, Elsharnoby H, Chacko P, et al. Impact of COVID-19 pandemic on the incidence and prevalence of postural orthostatic tachycardia syndrome. Eur Heart J Qual Care Clin Outcomes. 2025;11:698-704
- Reis Carneiro D, Rocha I, Habek M, et al. Clinical presentation and management strategies of cardiovascular autonomic dysfunction following a COVID-19 infection: a systematic review. Eur J Neurol. 2023;30:1528-1539
- Bushi G, Gaidhane A, Ballal S, Kumar S, et al. Postural orthostatic tachycardia syndrome after COVID-19 vaccination: a systematic review. BMC Cardiovasc Disord. 2024 (doi 10.1186/s12872-024-04315-x)
- What Is POTS? A Plain-Language Explanation
- How to Test for POTS at Home: The 10-Minute Stand Test
- POTS Symptoms: The Common Ones and What They Mean
- How POTS Is Diagnosed: Criteria, Stand Test and Tilt Table
- NASA Lean Test for POTS: How to Do It at Home
- Do I Have POTS? What to Check Before You See a Doctor
- Tests to Ask For When You Suspect POTS
- Why Does My Heart Race When I Stand Up?
- POTS Heart Rate: How to Graph It with Apple Watch
- Orthostatic Intolerance: Types and How POTS Fits In
- Why Blood Pressure Matters in a POTS Stand Test
- What Is Dysautonomia, and How Does It Relate to POTS?
- What Causes POTS? Subtypes, Triggers and What the Evidence Shows
- POTS in Teens, Young Adults and During Pregnancy
- POTS Treatment Overview: What Guidelines Recommend First
- Fluids and Salt for POTS: What the Trials Show
- Compression and Exercise for POTS: Two First-Line Treatments
- POTS Medications: What Each One Does and What the Trials Show
- Living With POTS: Triggers, Pacing, Heat, Meals and Sleep
Want a record to bring to your visit? The POTS app guides the stand test at home and graphs your heart rate. See the app