Long COVID and POTs

Our guest today is Chelsea Weaver, a 31-year-old living in Tennessee. She has a beautiful little girl that is just over 2 years old, a wonderful husband, and they all live on a quiet farm property.  Before coming down with COVID, she was a surgical technologist.   She used to assist in open heart surgery as well as some other specialties but hasn't been able to function in her career for about two years now.  Unfortunately, her COVID symptoms have morphed into Long COVID (specifically POTs or Postural Orthostatic Tachycardia Syndrome.)  

While the global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections has slowed, many people suffer long-lasting symptoms, a condition known as post-acute sequelae of COVID 2019 (COVID-19) (PASC), or long COVID. Even though PASC is not widely described, it is most commonly defined as COVID-19 symptoms that continue longer than 30 days.

PASC can manifest as a wide range of symptoms, many exhibiting autonomic characteristics. An autonomic nervous system illness, postural orthostatic tachycardia syndrome (POTS), strongly connected with a prior viral infection, is the most prevalent autonomic diagnosis correlated with PASC.

The most prevalent symptoms were brain fog, exhaustion, shortness of breath with exercise, headache, palpitations, body pains, tachycardia, and lightheadedness, consistent with previous research that found many of the same symptoms in individuals with PASC.

A COMPASS-31 score of above 20 was found in 67% of PASC patients, indicating autonomic dysfunction with moderate to severe. The COMPASS-31 consists of 31 questions that fall into 6 domains of dysautonomia: orthostatic intolerance (4 items), vasomotor dysfunction (3 items), secretomotor dysfunction (4 items), GI dysfunction (12 items; includes gastroparesis, constipation, and diarrhea), urinary dysfunction (3 items), and pupillomotor dysfunction (5 items). An answer was scored as zero when it was not assigned a point. A raw domain score was obtained by adding together points within each domain. The total score within each domain was weighted as previously described15 and then added together to give a total score ranging from 0 to 100. The maximum weighted scores for each subdomain are as follows: 40 for orthostatic intolerance, 5 for vasomotor dysfunction, 15 for secretomotor dysfunction, 25 for GI dysfunction, 10 for urinary dysfunction, and 5 for pupillomotor dysfunction.

CONCLUSIONS: "Our study finds that 67% of individuals with Long COVID are developing dysautonomia. That’s an estimated 38 million Americans with Long COVID dysautonomia, and millions more around the world,” says Lauren Stiles, President of Dysautonomia International and Research Assistant Professor of Neurology at Stony Brook University. (CREDITS: https://bit.ly/3VzS7BQ & https://bit.ly/3VPnU1u )