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POTS and COVID-19: Vaccine Link, Infection Risk, and the Hidden Impact of Mild Cases

Postural Orthostatic Tachycardia Syndrome (POTS) is a condition that can leave you dizzy, fatigued, and with a racing heart when you stand up. Recent research has explored whether COVID-19 vaccines or infections might trigger or worsen POTS. A 2024 systematic review in BMC Cardiovascular Disorders suggests a possible link between mRNA COVID-19 vaccines and POTS, but studies also claim the risk is far higher after a COVID-19 infection. But are these findings airtight? And what about mild cases that slip under the radar? Let’s dive in.

What the Research Says

The Nature Cardiovascular Research study (2022) analyzed 284,592 vaccinated individuals and found that the odds of POTS were higher 90 days post-vaccination compared to pre-vaccination, but 5.35 times lower than after a COVID-19 infection. The BMC review, analyzing 10 studies with 284,678 participants, confirmed a rare association with mRNA vaccines, noting symptoms like dizziness and palpitations often appeared days to weeks after vaccination. Most patients had preexisting conditions like autoimmune disorders or prior COVID-19 infections, which could predispose them to POTS.

[](https://www.nature.com/articles/s44161-022-00177-8)[](https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-024-04315-x)

Challenges to the Findings

Not everyone buys the claim that POTS is more likely after infection. Here’s why:

  • Study Limitations: The Nature study’s crude risk comparisons weren’t fully adjusted for factors like prior health conditions, which could skew results. A 2023 correction admitted that definitive causality is hard to pin down.
    • [](https://www.nature.com/articles/s44161-023-00339-2)
  • Diagnostic Bias: Severe COVID-19 cases are more likely to prompt medical visits, potentially inflating infection-related POTS diagnoses compared to milder vaccine-related cases.
    • [](https://www.nature.com/articles/s44161-022-00194-7)
  • Causality Questions: Some argue vaccines or infections might unmask existing POTS rather than cause it, especially in those with conditions like Ehlers-Danlos syndrome.
    • [](https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-024-04315-x)

The Issue of Unreported Mild Cases

Mild POTS cases, especially after mild or asymptomatic COVID-19 infections, might be flying under the radar. A Cleveland Clinic study (2022) found POTS symptoms even in mild COVID-19 cases, suggesting many go undiagnosed if symptoms are subtle, like occasional dizziness mistaken for fatigue. This underreporting could mean the true risk of POTS post-infection (or post-vaccination) is higher than reported, muddying the comparison. Diagnosing POTS requires specialized tests, which aren’t routine for mild symptoms, further hiding these cases.

[](https://consultqd.clevelandclinic.org/mild-covid-19-linked-to-postural-orthostatic-tachycardia-syndrome)

What This Means for You

While POTS after vaccination is rare, the risk appears lower than after COVID-19 infection—but the data isn’t bulletproof. Unreported mild cases could be skewing our understanding, and more research is needed to clarify the true risks. If you’re experiencing symptoms like a racing heart or dizziness, especially with a history of COVID-19 or autoimmune issues, talk to your doctor. Tests like a tilt table can help diagnose POTS, and treatments like hydration, salt intake, or beta-blockers can make a difference.

[](https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/covid19-and-pots-is-there-a-link)

Explore More

Want to dig deeper? Check out these sources:

  • Nature Cardiovascular Research on POTS risks post-vaccination and infection.
    • [](https://www.nature.com/articles/s44161-022-00194-7)
  • Johns Hopkins Medicine on POTS and COVID-19.
    • [](https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/covid19-and-pots-is-there-a-link)
  • Heart Rhythm for studies on autonomic dysfunction.
    • [](https://www.heartrhythmjournal.com/article/S1547-5271%2823%2902703-0/abstract)

Have you noticed POTS-like symptoms after COVID-19 or vaccination? Share your thoughts below!

Disclaimer: Always consult a healthcare professional for medical advice. This post is for informational purposes only.

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