Karolinska Institutet’s Long COVID POTS study finds 31% of long COVID patients—mostly middle-aged women—develop POTS, revealing hidden heart risks.
News Delhi – In a groundbreaking revelation shaking the medical community, a new Long COVID POTS study from Sweden’s Karolinska Institutet has uncovered a dramatic connection between long COVID and postural orthostatic tachycardia syndrome (POTS).
This unusual heart rhythm disorder—causing a racing heartbeat upon standing—affects nearly one-third of patients with severe long COVID, predominantly middle-aged women.
Published in Circulation: Arrhythmia and Electrophysiology, the research highlights the hidden cardiovascular toll of long COVID, showing that even years after infection, the virus’s lingering effects can disrupt the body’s autonomic balance.
Long COVID POTS: A Hidden Cardiac Crisis After COVID
As long COVID continues to impact millions worldwide in 2025, the Karolinska Institutet POTS study underscores an urgent need for routine cardiovascular screening. For those suffering from fatigue, dizziness, or heart palpitations after COVID-19, recognizing POTS could be a crucial step toward recovery.
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What Is POTS? Understanding the ‘Dizzying’ Heart Condition
Postural Orthostatic Tachycardia Syndrome (POTS) is a form of dysautonomia—a malfunction of the autonomic nervous system that controls heart rate, blood pressure, and breathing. The hallmark feature is a spike in heart rate of 30 beats per minute or more upon standing, often leading to dizziness or even fainting due to reduced blood flow to the brain.
Common POTS Symptoms
- Dizziness or lightheadedness (especially upon standing)
- Rapid heartbeat or palpitations
- Severe fatigue and muscle weakness
- Brain fog and difficulty concentrating
- Chest pain, shortness of breath, and nausea
- Tremors, sweating, and body temperature imbalance
These symptoms overlap significantly with long COVID, making diagnosis difficult without specialized tests such as a head-up tilt test or active stand test.
Long COVID POTS: Why POTS Occurs After COVID
While the exact cause remains unclear, experts believe viral infections like COVID-19 may trigger inflammation or nerve damage in blood vessel–controlling nerves. Other contributing factors include genetic predisposition, autoimmune reactions, and hormonal shifts, explaining why women aged 30–50 are at greater risk.
Before the pandemic, POTS affected fewer than 1% of Sweden’s population. Post-COVID data now suggest a sharp rise linked to the virus.
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Key Findings from the Karolinska Institute Long COVID POTS Study
Led by doctoral researcher Mikael Bjornson at Karolinska Institute’s Department of Medicine (Solna), this largest-ever prospective study examined 467 non-hospitalized long COVID patients – all with persistent symptoms and at least 50% sick leave – at a median of 12 months post-infection.
Shocking Results
- 31% Diagnosed with POTS: 143 participants met full clinical criteria through cardiologist evaluation and specialized cardiac testing.
- 27% Showed POTS-like Symptoms: Without meeting full diagnostic standards.
- Demographics: POTS patients were 91% female, with an average age of 40 years. Most were healthy, active individuals before infection.
Impact on Daily Life
- Reduced Physical Capacity: POTS patients walked shorter distances (448m vs. 509m in controls) during a 6-minute walk test.
- Lower Activity Levels: They reported more sedentary lifestyles and chronic exhaustion.
- Symptom Overlap: POTS and long COVID shared many symptoms, making clinical differentiation challenging.
The study was funded by the Swedish Research Council and the Heart-Lung Foundation, conducted in collaboration with Karolinska University Hospital. Researchers plan to track the cohort for 4–5 years for long-term outcomes.
Long COVID POTS: A Wake-Up Call for Global Health
Mikael Bjornson, lead author of the study, noted:
“We can now say with certainty that POTS is a very common condition in patients with long COVID. This knowledge is vital for healthcare workers and patients alike.”
Associate Professor Judith Bruchfeld, senior consultant at Karolinska, emphasized accessibility:
“POTS can be detected through simple, low-cost tests at all healthcare levels. Early diagnosis can significantly improve quality of life.”
Managing Long COVID POTS: Treatment Options That Work
The Long COVID POTS study brings hope—POTS is manageable with tailored, multi-step care:
- Lifestyle Adjustments:
- Drink 2–3 liters of fluids daily
- Increase salt intake (up to 10g/day)
- Use compression stockings
- Sleep with the head of the bed elevated
- Exercise Programs:
Gradual aerobic conditioning—such as recumbent cycling—can rebuild stamina. - Medications:
- Beta-blockers (e.g., propranolol) to control heart rate
- Fludrocortisone to boost blood volume
- Midodrine to tighten blood vessels
- Supportive Therapies:
Physical therapy, pacing strategies, and cognitive behavioral interventions can help patients manage symptoms and regain independence.
Early intervention can reduce symptom burden by up to 70% in responsive cases.
Long COVID in 2025: A Lingering Global Crisis
Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), refers to symptoms persisting beyond four weeks after infection. As of 2025, 10–20% of COVID-19 survivors globally still report ongoing issues, translating to tens of millions of cases.
Common long COVID symptoms include:
- Persistent fatigue and weakness (~11% prevalence)
- Palpitations and shortness of breath
- Brain fog, sleep disturbances, and joint pain
- Depression and reduced quality of life
Women remain disproportionately affected, with many reporting prolonged disability or work absence, mirroring the Karolinska study’s findings.
Implications for Healthcare: Time for Routine Screening
This Karolinska Institutet Long COVID POTS study is more than data—it’s a public health warning. Medical professionals worldwide are now urging routine screening for POTS in patients with post-COVID fatigue or orthostatic intolerance, especially among women.
Early recognition can prevent deconditioning and chronic disability, reduce healthcare costs, and restore patients’ quality of life.
Long COVID POTS: Awareness and Action
As the pandemic’s shadow stretches into its fifth year, studies like Karolinska’s highlight that long COVID is not just about lingering fatigue—it’s a systemic condition affecting the heart and nervous system.
If you or someone you know experiences dizziness, palpitations, or exhaustion after COVID-19, consult a cardiologist or dysautonomia specialist. Awareness and early intervention could be life-changing.
Stay informed with The Interview Times for verified, science-based coverage on long COVID POTS research.