York Hospital consultant may have treatment to fight Long Covid

A YORK heart specialist says he thinks many patients with Long Covid may actually have a condition called POTS – and could benefit from treatments used for patients with the syndrome.

Dr. Sanjay Gupta, Consultant Cardiologist at York Hospital, is an expert on POTS, or Postural Tachycardia Syndrome.

The condition can leave sufferers weak, constantly exhausted and sometimes even unable to walk.

The condition is thought to be caused by a malfunction in the autonomic nervous system which regulates heart rate, blood pressure, digestion and sweating.

Symptoms can include palpitations, dizziness, brain fog, chest pain, bowel problems, shortness of breath and excessive sweating – similar to symptoms reported by many Long Covid patients.

And like Long Covid, POTS often develops as a result of viral or other infection, says Dr. Gupta. Symptoms can last for years and ruin patients’ lives. “Patients may feel that their life is not worth living.”

According to Dr. Gupta, one of the characteristics of POTS is that the symptoms get worse when you stand up. When a healthy person stands, the blood vessels narrow and the heart rate increases slightly to maintain blood supply to the heart and brain.

In people with POTS, this automatic adjustment to standing does not work properly, resulting in a dramatically increased heart rate and impaired blood flow to the brain.

“So patients often try to avoid getting up and spend a lot of time sitting or lying down,” Dr. Gupta said. “A lot of patients use wheelchairs.”

Dr. Gupta thinks that, in people with POTS, an infection may have exposed an underlying “genetic vulnerability”.

This, in turn, causes an “imbalance” in the autonomic nervous system, he says – with consequences that persist long after the initial infection has cleared.

Dr. Gupta started a POTS clinic at York Hospital, which has now become a regional center for POTS.

It uses a four-pronged approach to dealing with POTS. That implies:

l medicines to regulate blood pressure and heart rate

l lifestyle and dietary advice, including increased fluid and salt intake

l physiotherapy, including the use of compression stockings

l an advocacy service, which contacts employers or others on behalf of patients, to explain their condition.

“We are caring for nearly 600 patients – many of whom were in wheelchairs and who, thanks to treatment, are walking again,” he said.

Since the emergence of Long Covid, however, he has recognized that in many ways it is similar to POTS. In fact, he says, it may be the same condition.

“I suspect that many patients with Long Covid may also improve with some of our treatments,” he said.

POTS is a recognized condition, Dr. Gupta points out. But because it is difficult to diagnose, it is often not recognized by general practitioners. Those affected may end up being marginalized or misdiagnosed.

Patients with POTS-like conditions should ask their GP for a referral to a specialist like him, he says. “They should go to their GP and say ‘I think I may have POTS’.”

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