In the quiet machinery of the body, the simple act of standing has become a diagnostic threshold — one that separates the healthy from those caught in the long aftermath of COVID-19. Researchers at Adelaide University have found that nearly two-thirds of Long COVID patients meet the criteria for POTS, a disorder of the autonomic nervous system long known for its elusiveness and its power to unravel ordinary life. The discovery, published in the Journal of the American Heart Association, offers not only a clearer map of overlapping suffering, but a more navigable path toward recognition, treatm
Study links POTS to nearly two-thirds of Long COVID cases, offering diagnostic clarity
58.3% of Long COVID participants unable to return to work; 95.8% of POTS participants not in full-time employment, causing significant impact on work and social participation.
Nearly two-thirds of Long COVID patients also met diagnostic criteria for POTS
Mark
So the study found that nearly two-thirds of Long COVID patients also have POTS. That's a huge overlap. Does that mean Long COVID causes POTS, or is it the other way around?
Mimi
The study doesn't establish causation either direction. What it shows is that the two conditions co-occur frequently and share similar symptoms. The researchers found low-grade inflammation in both groups, which might be a common driver, but they're careful not to claim one causes the other.
Luke
Right, and that's important to flag. The study is correlational. We know 62.5 percent of their Long COVID sample met POTS criteria, but we don't know if that percentage holds across all Long COVID populations, or if there's something about who was enrolled in this particular study.
Mark
The standing test—the one that measures heart rate change—that seems like a straightforward diagnostic tool. Why hasn't it been used more widely already?
Mimi
POTS is genuinely difficult to diagnose because the symptoms are so nonspecific. People often get labeled with anxiety or deconditioning before anyone thinks to do a standing test. The value of this research is that it gives clinicians a reason to look for POTS when they see Long COVID, rather than treating the conditions as separate mysteries.
Luke
Though we should note: the study measured heart rate changes in a controlled setting. Real-world diagnosis involves more than one test, and the standing test itself has limitations. A 35 beat-per-minute increase is suggestive, but not every person with that response will have POTS, and not every person with POTS will show that exact response.
Mark
The work situation is striking—58 percent of Long COVID patients unable to return to work. Is that because of POTS specifically, or Long COVID more broadly?
Mimi
The study doesn't separate those out. What we know is that among the Long COVID participants, that's the employment rate. Among the POTS group, it was even worse—only 4.2 percent in full-time work. So both conditions are associated with significant work disability.
Luke
And that's a real limitation of the reporting. We don't know whether identifying POTS in Long COVID patients would actually improve employment outcomes, or whether the underlying dysfunction is too severe for that distinction to matter practically. The study suggests earlier diagnosis could help, but it doesn't measure whether it does.
Mark
What about the inflammation finding? Is that a potential treatment target?
Mimi
The researchers found subtle differences in inflammatory markers, which suggests inflammation may play a role. But they're not claiming they've identified a specific inflammatory pathway that can be treated. It's an early clue, not a solution.
Luke
Exactly. The study opens a door but doesn't walk through it. We have suggestive evidence of inflammation, but no clinical trial showing that treating inflammation in POTS or Long COVID patients improves outcomes. That's the next step, and it's not guaranteed to work.
Der Puls
- Millions of Long COVID sufferers have been living without a name for what is happening inside them — and a racing heart upon standing may finally provide one.
- A heart rate surge of 35 beats per minute when standing, compared to 13 in healthy people, reveals that Long COVID is reshaping the body's most automatic functions.
- Low-grade inflammation detected in blood tests suggests the immune system may be quietly sustaining the very dysfunction that keeps patients bedridden and out of work.
- With 58% of Long COVID participants unable to return to work and nearly all POTS patients outside full-time employment, the economic and social toll demands urgent clinical attention.
- A straightforward standing test now gives clinicians a concrete reason to investigate POTS in Long COVID patients — transforming a diagnostic maze into a more direct corridor.
In the quiet machinery of the body, the simple act of standing has become a diagnostic threshold — one that separates the healthy from those caught in the long aftermath of COVID-19. Researchers at Adelaide University have found that nearly two-thirds of Long COVID patients meet the criteria for POTS, a disorder of the autonomic nervous system long known for its elusiveness and its power to unravel ordinary life. The discovery, published in the Journal of the American Heart Association, offers not only a clearer map of overlapping suffering, but a more navigable path toward recognition, treatment, and the possibility of return.
When a person stands up, the healthy body barely notices — heart rate climbs by about 13 beats per minute and life continues. But for those living with Long COVID, that same movement can send the heart racing by 35 beats per minute or more, a signal that something deeper has gone wrong in the body's invisible control systems.
A new study from Adelaide University, conducted with SAHMRI and published in the Journal of the American Heart Association, compared heart rate responses and immune markers across people with POTS, people with Long COVID, and healthy volunteers. The results were striking: 62.5 percent of Long COVID participants also met the diagnostic criteria for POTS — a disorder of the autonomic nervous system that governs heart rate, blood pressure, and other functions the body performs without thought.
POTS has long been a condition that eludes diagnosis. Its symptoms — dizziness, fatigue, brain fog, palpitations — mirror those of many other illnesses, and patients often spend years cycling through inconclusive tests. The same symptoms define Long COVID, making the overlap both clinically significant and, for patients, deeply familiar.
Lead researcher Dr. Marie-Claire Seeley noted that POTS can be identified through a relatively simple standing test, giving clinicians a clearer pathway when Long COVID patients present with these symptoms. Blood tests also revealed subtle inflammatory differences between groups, pointing toward low-grade inflammation as a possible mechanism linking the two conditions.
The human cost embedded in these findings is severe. Among Long COVID participants, 58.3 percent had not returned to work since their infection. Among those with POTS, nearly 96 percent were not in full-time employment. These numbers describe not a medical footnote but a widespread collapse of ordinary life — income lost, social connection severed, daily functioning diminished.
Dr. Seeley emphasized that earlier recognition of POTS within Long COVID cases could open doors to more targeted treatment and support, offering patients a genuine chance to reclaim some of what the illness has taken from them.
When you stand up, your heart rate climbs. For most people, it rises by about 13 beats per minute—a small adjustment the body makes automatically to keep blood flowing to the brain. But for people with certain conditions, that standing test becomes a window into something more troubling. A new study from Adelaide University has found that nearly two-thirds of people living with Long COVID meet the diagnostic criteria for postural orthostatic tachycardia syndrome, or POTS, a condition in which the heart rate surges far more dramatically when a person shifts from lying or sitting to standing.
The research, conducted in partnership with SAHMRI and published in the Journal of the American Heart Association, compared heart rate responses, symptom patterns, and immune markers across three groups: people with POTS, people with Long COVID, and healthy volunteers. When standing, the POTS group's heart rates jumped an average of 46 beats per minute, while the Long COVID group saw increases of 35 beats per minute. The gap between these two groups and the healthy control group—which averaged just 13 beats per minute—was striking. The overlap was even more striking: 62.5 percent of the Long COVID participants in the study also satisfied the diagnostic criteria for POTS.
POTS is a disorder of the autonomic nervous system, the network of nerves that governs functions the body performs without conscious thought—heart rate, breathing, digestion, blood pressure regulation. In Australia alone, roughly 800,000 people live with POTS. The condition is notoriously difficult to pin down because its symptoms—dizziness, fatigue, brain fog, heart palpitations—can mimic or overlap with dozens of other illnesses. People often spend years seeking a diagnosis, cycling through specialists and tests that come back inconclusive. The same symptoms that define POTS are also hallmarks of Long COVID, the lingering illness that affects some people weeks or months after a coronavirus infection.
Dr. Marie-Claire Seeley, the lead researcher at Adelaide University's Rosemary Bryant AO Research Centre, emphasized the practical significance of the finding. POTS can be identified through a relatively straightforward standing test, she noted, making it possible for clinicians to recognize the condition more readily. When Long COVID patients present with dizziness, fatigue, brain fog, or a racing heart, doctors now have a clearer reason to investigate whether POTS is part of the picture. Earlier identification could open pathways to more targeted treatments and support tailored to the specific dysfunction driving symptoms.
The study also uncovered early biological clues. Blood tests revealed subtle differences in inflammatory markers between the groups, suggesting that low-grade inflammation may contribute to the development or persistence of POTS. This finding points toward a potential mechanism—a way to begin understanding not just that the two conditions overlap, but why.
The human cost of both conditions is substantial. Among the Long COVID participants in the study, 58.3 percent had been unable to return to work since their infection. Among those with POTS, only 4.2 percent were engaged in full-time work or education, meaning roughly 95.8 percent were not in full-time employment. These are not minor quality-of-life issues. They represent a profound disruption to people's ability to earn income, maintain social connections, and participate in ordinary daily life. Dr. Seeley underscored this reality, noting that better recognition and earlier diagnosis could make a meaningful difference for people living with these debilitating symptoms, helping them access treatment and support that might allow them to reclaim some measure of their former functioning.
The research is believed to be the first to examine autonomic symptoms, heart rate response, inflammatory markers, and autoantibodies together in people with Long COVID, POTS, and healthy controls. That comprehensiveness matters. It suggests that clinicians treating Long COVID patients now have a more complete picture of what might be happening in their patients' bodies, and a clearer diagnostic pathway to follow.
Bemerkenswerte Zitate
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.— Dr. Marie-Claire Seeley, lead researcher at Adelaide University
Better recognition and earlier diagnosis could make a real difference for people living with debilitating symptoms, helping them access more targeted treatment and support.— Dr. Marie-Claire Seeley
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