Many cases of POTS seem to start after a viral illness. Usually the preceding viral illness did not cause the occurrence of POTS. Instead, the viral illness attracts attention to the annoying symptoms that follow the infection. Most viral infections leave individuals washed out and weak with an increased need for more sleep. The more severe the viral illness, the more likely the post-viral symptoms can be severe and incapacitating. We all know that more individuals with COVID-19 infections have minimal-to-mild symptoms, than those who experience life-threatening illnesses. Frequently symptoms like dizziness, fatigue and headaches follow the prior illness and are naturally attributed to the preceding viral infection.

Because Covid-19 infections are rampant in the community, most individuals exhibiting post-viral fatigue today are the result of a recent Covid-19 infection. However, it’s also possible that some of the cases of apparent post-viral fatigue are actually caused by POTS. Mild undetected POTS may have existed prior to the Covid infection, and the overt POTS symptoms (fatigue, headaches, rapid heart, visual and abdominal symptoms) only become more prominent following the Covid illness. Adolescents and young adults who demonstrate symptoms suggestive of POTS following any viral illness, should be evaluated for POTS. A number of such POTS cases have been recognized recently following a relatively insignificant Covid-19 infection.

Adolescents and young adults need to be on the look-out for the occurrence of fatigue, headaches, rapid heart, visual and abdominal symptoms following any viral-like illness, with worsening of symptoms when upright and improvement when lying down. This group of symptoms strongly suggests the presence of POTS (postural orthostatic tachycardia syndrome) and requires medical evaluation.

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