Key result
A triple analysis of 24-hour ECG recordings identified postural orthostatic tachycardia syndrome in long COVID patients, characterized by a higher number of heart rate spikes per hour (1.47 vs 0.68) compared to those without POTS.
Why the study?
POTS is commonly observed as a sequelae of coronavirus disease infection, but methods directing clinical suspicion toward diagnosis using 24-hour ECG needed development and testing.
Does a triple analysis of 24-hour ECG recordings accurately detect postural orthostatic tachycardia syndrome (POTS) in patients with long coronavirus disease?
Case-Control (n=200)
Yes
Does a triple analysis of 24-hour ECG recordings accurately detect postural orthostatic tachycardia syndrome (POTS) in patients with long coronavirus disease?
Absolute Event Rate: 1.47% vs 0.68%
p-value: p=<0.01
A triple analysis of 24-hour ECG recordings can accurately identify POTS in patients with long COVID, offering a simple, accessible screening tool to direct clinical suspicion and enable early treatment.
May aid POTS screening in long COVID via 24-hour ECG; hypothesis-generating and requires prospective validation.
Background: Cardiovascular autonomic dysfunction is a major complication in a large proportion of patients with long coronavirus disease (LC). As one of the most typical phenotypes of cardiovascular autonomic dysfunction, postural orthostatic tachycardia syndrome (POTS) is commonly observed as a sequelae of coronavirus disease infection. Objective: This study aimed to develop and test a 24-hour electrocardiogram (ECG) recording to direct the clinical suspicion toward the diagnosis of POTS. Methods: Consecutive patients referred to the Karolinska University Hospital in Stockholm from April 2021 to April 2022 were included. Patients with POTS were compared with patients with LC without POTS (verified by active standing tests) and control healthy subjects according to 3 specific analyses based on 24-hour ECG recording: (1) heart rate (HR) spikes of > 30 beats per minute, (2) awakening HR increase, and (3) HR variability (root mean square of successive difference). The control group consisted of healthy subjects from the database of the University Hospital of Saint-Etienne. Results: < .01) compared with patients with LC without POTS (n = 55) and healthy subjects. Conclusion: A triple analysis of 24-hour ECG recordings could reveal a characteristic POTS signature in LC. More research in other populations is needed to draw any firm conclusions about its generalizability.
No takes yet. Share an insight, caveat, or question.
Hupin et al. (2025) conducted a case-control in Long coronavirus disease (LC) and Postural orthostatic tachycardia syndrome (POTS) (n=200). 24-hour electrocardiogram (ECG) recording (triple analysis) vs. Patients with long COVID without POTS and healthy subjects was evaluated on Heart rate spikes per hour (>30 beats per minute) (p=<0.01). A triple analysis of 24-hour ECG recordings identified postural orthostatic tachycardia syndrome in long COVID patients, characterized by a higher number of heart rate spikes per hour (1.47 vs 0.68) compared to those without POTS.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: