POTS following COVID-19 vaccination
Postural orthostatic tachycardia syndrome has not only occurred as a
part of the “long COVID” syndrome following SARS-CoV-2 infection but
has also been reported after COVID-19 vaccination. However, the
incidence rate is multiple times higher after infection than after
vaccination[44, 45]. POTS is among the wide range of cardiovascular
and neurological complications imposed by SARS-CoV-2 vaccination[5-7,
46].
Previously POTS had been rarely reported following vaccination, except
for HPV vaccination[47-49]. With the introduction of SARS-CoV-2
vaccines, the reported cases of new-onset POTS have increased[45,
50]. Most cases of vaccine-associated POTS occurred within one month
of receiving COVID vaccines. Vaccine-induced phenomena are usually of
autoimmune origin; thus, autoimmunity is the most probable explanation
for this autonomic dysfunction disorder following SARS-CoV-2
vaccination. The vaccine is believed to trigger. This results from
molecular mimicry between certain vaccine components and human proteins
in the above receptors [51, 52]. Besides POTS, other autonomic
dysfunctions caused by SARS-CoV-2 include sympathetic adrenergic and
postganglionic sympathetic pseudomotor dysfunction[53, 54]. This
COVID vaccine-related adverse event has been more reported after
receiving mRNA vaccines, compared with other vaccine
platforms[55-57]. Management of vaccine-related POTS is the same as
the one due to other causes; however, its autoimmune origin suggests
that unresponsive cases can be successfully treated with intravenous
immunoglobulin (IVIG)[58].