Could Long Covid be an unrecognized nervous system problem?

Some people with long-term Covid might actually suffer from a common but little-known ‘vertigo’ condition linked to nervous problems.

Persistent symptoms of coronavirus infection affect up to one in 20 people and can include palpitations, dizziness, and fainting – which are also key features of postural tachycardia syndrome, or PoTS.

Doctors now say the similarity between the two conditions may mean that Covid infection could trigger PoTS in some cases.

But not all long Covid clinics routinely test for the syndrome, says a leading clinician, which means many patients may go undiagnosed and not receive effective treatments.

One approach to tackling PTSD is to consume more salt, which increases blood pressure and helps relieve symptoms. Oddly, a patient told The Mail on Sunday that she found some relief from eating Hula Hoops and salted nuts every day.

Dr Lesley Kavi, a former general practitioner who now heads the charity PoTS UK, said: ‘We believe the pandemic may have caused an explosion of cases – there are specialist services for PoTS in the NHS, and they report that many of their new referrals are from patients who started having problems after catching Covid.

In December, the National Institute for Health and Care Excellence (NICE) released guidelines recommending testing long Covid patients for PoTS. However, Dr Kavi added: “Patients say it is not being done. Instead, they go to specialist clinics after finding out about the disease through support groups on Facebook and other websites.

The syndrome is caused by abnormal functioning of the autonomic nervous system, which manages involuntary bodily processes, one of which is the regulation of blood pressure and heart rate when we change posture, such as going from lying down to lying down. standing position. In this movement, the effect of gravity means that there is a slight decrease in the amount of blood flow to the upper body, but in most people the nervous system quickly recalibrates – the blood vessels in the limbs. lower cells narrow and the heart rate increases slightly to maintain blood supply to the heart and brain.

In people with PoTS, it doesn’t happen as quickly. As a result, when there is a drop in blood flow to the upper body, the heart begins to race in order to compensate, triggering multiple symptoms, including extreme dizziness and even fainting. People with the condition also experience fatigue and “brain fog” – feelings of confusion.

The condition can become debilitating, affecting the ability to work or enjoy daily activities. Some end up relying on a wheelchair.

Before the pandemic, it is believed that around 130,000 people in the UK were affected by PoTS, most often women under the age of 50.

It is not clear why it affects women more than men.

Patients are also more likely to suffer from Chronic Fatigue Syndrome and Ehlers-Danlos Syndrome, a set of inherited syndromes that cause joints to be very flexible and skin that is stretchy and fragile. Due to a lack of awareness of PoTS, patients typically experience symptoms for seven years before seeking a diagnosis.

Dr Kavi said: “We believe that in some people the nerve issues causing the syndrome are initially triggered by a viral infection, so the Covid link did not surprise specialists.

But many healthcare professionals haven’t heard of PoTS, so don’t consider it even if patients have typical symptoms.

To add to the difficulties that sufferers face, there are few specialists in the UK, which means waiting lists for treatment can be eight months or more.

The standard test is simple: patients are asked to lie down for a few minutes, then stand up. Their heart rate, blood pressure and symptoms are recorded for ten minutes. If there is a sustained increase in heart rate of more than 30 beats per minute in adults and 40 beats per minute in children, then a diagnosis of PoTS may be considered.

“We don’t know why the long Covid clinics don’t do this,” Dr Kavi said. “The lack of time and the lack of face-to-face meetings could be part of it.

“We started recommending that patients try it out for themselves at home – making sure someone else is with them and that they are in front of a chair or a wall, in case they get stuck. would feel very dizzy or passed out. “

Armed with this information, patients should then seek advice from their GP, as there are effective ways to combat PoTS.

“Staying hydrated and consuming more salt in the diet slightly increases blood pressure, which may alleviate symptoms,” Dr. Kavi explained. “Muscle strengthening exercises for the legs can also stimulate circulation. Medicines may be prescribed to regulate heart rate and blood pressure.

One patient who has found relief since being diagnosed and starting treatment is Sian Griffiths, 43, of Anglesey. The physiotherapist led an active life, mountain biking and walking in the hills, until May of last year when she caught Covid. She said, “I just didn’t seem to be doing any better. Months later, I still couldn’t make the five-minute walk to my parents’ house. I should sit on the sidewalk to catch my breath.

While researching online, Sian found a PoTS group on Facebook. “I saw a live talk about it and the doctor described my symptoms perfectly,” she says.

“I would find that when I got up in the morning, or tried to climb the stairs, my heart was racing and I felt dizzy – spaced out and disoriented – and it took years for everything to become clear again. ‘

After being referred by her GP to a PoTS specialist in Stoke – “I became deprived because the wait on the NHS was very long,” she says – Sian was tasked with performing the test at home at different times of the day, measuring his heart rate after standing. Each time, her pulse increased by more than 30 beats per minute for more than ten minutes.

Her doctor then ordered other tests, including an ECG, which measures the electrical activity of the heart. She was also given a heart monitor to wear for 24 hours. Finally, in February, with all tests showing positive results, Sian was diagnosed with PoTS.

“I started taking tablets and swam, which I find I can do without getting dizzy,” says Sian. “Although I still find the walk very difficult, I was able to go out on an electric bike.

“Before going to bed, I mix a teaspoon of salt in some fruit juice, which I keep by the bed and take when I wake up. I then sit in my bed and let myself adjust.

“My specialist recommended that I start adding salt to my food and eating Hula Hoops and salted nuts, to increase my blood pressure.

‘I feel like I’m improving. My heart isn’t racing now, although I still have brain fog.

“I had to stop working last year because I felt too bad to take care of the patients, but I am determined to go back to the hills, do things I love and get on with my life again. hand.”