A review of the background to why postural orthostatic tachycardia syndrome (POTS) and long COVID appear similar to autoimmune diseases, together with key case studies and research findings supporting the association.
In 2002, San Francisco physician Sarah Schaefer suffered for an extended period from symptoms including dizziness, headaches and extreme fatigue before ultimately being diagnosed with POTS, a disorder of the autonomic nervous system. She was later diagnosed with Sjögren's disease, and her case is presented as an example in which her POTS symptoms turned out to be an early sign of an autoimmune disease.
Experts are increasingly recognising that autonomic disorders may be an element of autoimmune diseases, and research has shown that people with POTS are more likely to be diagnosed with an autoimmune disease. Specifically, one study found that 1 in 5 POTS patients may have an association with another autoimmune disease. A tendency toward positive autoimmune markers has also been observed.
Research also suggests that people with autoimmune diseases are more likely to develop autonomic disorders such as POTS. The same association has been observed in similar conditions, including long COVID and ME/CFS. POTS and related conditions are classified as infection-associated chronic illnesses in which stress on the immune system, including infection, pregnancy or trauma, may act as a trigger.