POTS and long COVID: what do studies show?

Studies describe autonomic problems after COVID-19, but how often they occur varies widely between cohorts and criteria.

8 sources
3 min read
Clinical review
Verified 8 November 2026

Key points

Cases of POTS have been described after infection with SARS-CoV-2, the virus that causes COVID-19. ^{[1, 2, 3]}
How often this happens is not yet known: published figures vary enormously and come from people who were already unwell, often seen in specialist clinics. ^[4]
A frequently quoted figure (about one in three) does not mean that one in three people with long COVID has POTS; its own authors rate its reliability as very low. ^[4]
Palpitations or dizziness after COVID do not necessarily mean POTS: many people who are evaluated do not meet its criteria. ^{[3, 5]}
POTS starting after an infection does not prove the infection caused it; the mechanisms remain hypotheses. ^{[6, 3]}

What are we talking about?

What the first studies describe

What is still debated

Cases of POTS diagnosed after SARS-CoV-2 infection have been described in several countries. These reports involve small groups of people referred to specialists. They show the phenomenon exists, not how often it occurs.

United States, 2021. Of 20 people referred for persistent symptoms after COVID, 15 were diagnosed with POTS. Six to eight months later, 17 still had symptoms and 12 of the 20 had not returned to work. ^[1] (case report)
United Kingdom, 2022. A series of 14 people describes presentations consistent with POTS after COVID. ^[2] (case report)
Austria, 2025. A specialist center in Innsbruck reviewed the records of people referred within six weeks of an infection: of 75 people, 22 had POTS, and in 39 others no autonomic nervous system disorder was found. The study also covered people referred after vaccination, a topic this page does not address. ^[3] (observational study)

The figure from the main review

An example of national guidance

Why might COVID play a role?

What we still don’t know

References and level of evidence

Blitshteyn S, Whitelaw S. Postural orthostatic tachycardia syndrome (POTS) and other autonomic disorders after COVID-19 infection: a case series of 20 patients. Immunologic Research 69(2):205-211 (erratum: 69(2):212) 2021. DOI: 10.1007/s12026-021-09185-5. PMID: 33786700.(case report)
Limitations: Series of 20 cases seen in a specialist clinic (15 POTS; at 6–8 months, 17 still symptomatic and 12 not back at work), no control group. An erratum was published (PMID 33851361).
Declared conflicts of interest: Declaration not consulted (full text not read as of 2026-11-08).
Gall NP, James S, Kavi L. Observational case series of postural tachycardia syndrome (PoTS) in post-COVID-19 patients. British Journal of Cardiology 29(1):3 2022. DOI: 10.5837/bjc.2022.003. PMID: 35747313.(case report)
Limitations: Series of 14 cases, no control group.
Declared conflicts of interest: L. Kavi chairs the patient charity PoTS UK (affiliation stated, no formal competing-interest declaration).
Leys F, Verginer M, Kirchler E, et al. Postural orthostatic tachycardia syndrome is the most frequent cardiovascular autonomic disorder following COVID-19 infection or vaccination. Journal of Neurology 272(12):783 2025. DOI: 10.1007/s00415-025-13518-x. PMID: 41275041.(observational study)
Limitations: Retrospective review of records from a single specialist center (Innsbruck); people referred within 6 weeks of an infection (75: 22 POTS, 39 with no autonomic disorder found) or a vaccination (26, not covered here); no control group; shows a sequence in time, not causation.
Declared conflicts of interest: The authors declare no conflict of interest.
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. Frontiers in Cardiovascular Medicine 12:1679252 (2025 volume, January 2026 issue) 2026. DOI: 10.3389/fcvm.2025.1679252. PMID: 41584279.(evidence synthesis)
Limitations: 21 studies included; POTS estimate: 15 studies, 1,058 people, 36.2% (95% CI 18.6–53.8), I² = 98%; after adjustment for publication bias (trim-and-fill): 8.7% (95% CI 0–30.8); certainty rated very low by the authors; mostly single-center studies; two different totals in the article (2,916 and 2,196). PubMed identifier not confirmed.
Declared conflicts of interest: The authors declare no commercial or financial relationships.
Haute Autorité de santé. Parcours de soins de l'adulte avec des symptômes prolongés de la Covid-19. Haute Autorité de santé (France), care-pathway guide (April 2024), appendix 1, table 7 2024.(guideline or consensus)
Limitations: French national care-pathway guide for adults with long COVID; not a general guideline on POTS.
Declared conflicts of interest: Not applicable (institutional document).
Vernino S, Bourne KM, Stiles LE, et al. Postural orthostatic tachycardia syndrome (POTS): State of the science and clinical care from a 2019 National Institutes of Health Expert Consensus Meeting - Part 1. Autonomic Neuroscience 235:102828 2021. DOI: 10.1016/j.autneu.2021.102828. PMID: 34144933.(guideline or consensus)
Limitations: Summary of an expert meeting; according to the authors, figures on associated conditions come from small samples or uncontrolled surveys.
Declared conflicts of interest: Competing interests declared individually in the article (consulting, grants, patents).
Raj SR, Guzman JC, Harvey P, et al. Canadian Cardiovascular Society Position Statement on Postural Orthostatic Tachycardia Syndrome (POTS) and Related Disorders of Chronic Orthostatic Intolerance. Canadian Journal of Cardiology 36(3):357-372 2020. DOI: 10.1016/j.cjca.2019.12.024. PMID: 32145864.(guideline or consensus)
Limitations: Professional society position statement; some recommendations rest on limited evidence.
Declared conflicts of interest: Declaration not consulted (full text not read as of 2026-11-08).
Raj SR, Fedorowski A, Sheldon RS. Diagnosis and management of postural orthostatic tachycardia syndrome. CMAJ 194(10):E378-E385 2022. DOI: 10.1503/cmaj.211373. PMID: 35288409.(evidence synthesis)
Limitations: Narrative, non-systematic review. Read: full text (cmaj.ca).
Declared conflicts of interest: All three authors declare research funding, fees or consulting activities; Raj and Sheldon also declare expert witness work or patents

Written by: AI-assisted literature research (ChatGPT) and AI-assisted writing (Claude)
Editor: Jean Viry-Babel
Review status: Clinical review: Dr Françoise Charmoillaux (anesthesiologist)
Approved on: 8 November 2026
Literature search: 8 November 2026
Last verified: 8 November 2026
Geographic scope: international, France
Audience: everyone
Conflicts of interest: No known conflict of interest.
Limitations of this page: Frequency estimates come from already symptomatic populations and highly heterogeneous studies; they do not measure individual risk. A link in time does not prove that the infection causes each case.