Standing heart rates reveal overlap between long COVID and POTS

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by University of Adelaide

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Dizziness, fatigue, brain fog and a racing heart. They're commonly associated with long COVID, but new Adelaide University research suggests that for some people, these symptoms may also be indications of postural orthostatic tachycardia syndrome (POTS), a debilitating and difficult-to-diagnose condition.

Conducted in partnership with SAHMRI, the study compared heart rate changes, symptoms and immune profiles among people with POTS, long COVID and healthy participants, finding that almost two-thirds (62.5%) of the long COVID participants also met the diagnostic criteria for POTS.

It's an important finding that could help explain some of the symptoms experienced by people with long COVID and help clinicians better diagnose, assess and treat POTS.

Published in the Journal of the American Heart Association, the study is believed to be the first to look at autonomic symptoms, heart rate response, inflammatory markers and autoantibodies in people with long COVID, POTS and healthy volunteers.

Specifically, the study showed that on standing, average heart rates rose by 46 beats per minute in the POTS group and 35 beats per minute in the long COVID group, compared with just 13 beats per minute in healthy volunteers.

The challenge of diagnosis

In Australia, around 800,000 people are living with POTS. It is a complex and often misunderstood condition affecting the system that controls automatic body functions such as heart rate, breathing and digestion. This can cause a wide range of seemingly unrelated symptoms, making the condition challenging to diagnose.

Lead researcher Dr. Marie-Claire Seeley from the Rosemary Bryant AO Research Center at Adelaide University said the findings could have important implications for how people with long COVID are assessed and treated.

"What's striking in this study is just how similar the two groups were. Almost two-thirds of the people with long COVID we studied met the diagnostic criteria for POTS," Seeley said.

"For people living with long COVID, symptoms such as dizziness, fatigue, brain fog and a racing heart can be debilitating. Our findings suggest that in some cases, POTS may be contributing to those symptoms.

"POTS can be assessed using a relatively simple standing test, so recognizing the signs is important. But because its symptoms overlap with other conditions, it can be challenging to diagnose.

"Recognizing the overlap between long COVID and POTS gives clinicians another avenue to investigate it, and identifying POTS earlier could help patients access more targeted treatment and support."

Inflammation and daily disruption

Researchers also uncovered early clues about the biology behind POTS, with blood tests revealing subtle differences in inflammatory markers that suggest low-grade inflammation may play a role.

The impact of POTS and long COVID on everyday life was significant. Almost six in 10 (58.3%) long COVID participants had been unable to return to work following their infection, while just 4.2% of participants with POTS were engaged in full-time work or education.

"These are conditions that can have an enormous impact on people's ability to work, socialize and participate in everyday life," Seeley said.

"Better recognition and earlier diagnosis could make a real difference for people living with debilitating symptoms, helping them access more targeted treatment and support."

Publication details

Marie‐Claire Seeley et al, Comparative Analysis of Circulating Cytokines and Adrenergic Autoantibodies in Postural Orthostatic Tachycardia Syndrome, Postacute Sequelae of SARS‐CoV‐2, and Healthy Controls, Journal of the American Heart Association (2026). DOI: 10.1161/jaha.125.048615

Journal information: Journal of the American Heart Association

Key medical concepts

Post-Acute COVID-19 SyndromeHeart RatePalpitationDizzinessMental Fatigue

Clinical categories

CardiologyNeurologyCommon illnesses & Prevention Provided by University of Adelaide Who's behind this story?

Sadie Harley

BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries. Full profile →

Robert Egan

Bachelor's in mathematical biology, Master's in creative writing. Well-traveled with unique perspectives on science and language. Full profile →

Citation: Standing heart rates reveal overlap between long COVID and POTS (2026, September 17) retrieved 17 September 2026 from https://medicalxpress.com/news/2026-09-heart-reveal-overlap-covid-pots.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.