*Only for medical professionals to read and reference
I'm not completely healed yet, but I feel like I'm getting better soon. Fortunately, it wasn't serious for me. Apart from the high fever, I had some respiratory symptoms. After generally recovering, I mainly feel that my physical strength seems to have declined a bit. Climbing stairs or lifting heavy objects is more likely to increase heart rate and cause breathing problems than before.
Yesterday, a colleague also said that it is easy to increase the heart rate after infection. I wonder if you have similar symptoms?
Recently, "Nature Cardiovascular Research" published a data analysis in the form of a cover study, using data from 300,000 people in the Los Angeles area to discuss the possibility of postural orthostatic tachycardia syndrome (POTS) after vaccination .
simply concluded that after received the COVID-19 vaccine, the probability of being diagnosed with POTS has indeed increased, and the risk increased by 52% compared to before vaccination; however, this number is still far lower than that of COVID-19 infection. The risk of POTS-related diseases being diagnosed after infection is 5.35 times higher than after receiving the vaccine .
This paper is this week's cover study of "Nature Cardiovascular Research"
Here we first introduce the disease Postural Orthostatic Tachycardia Syndrome (POTS). POTS is a common disease of the autonomic nervous system. The main symptom is that within 10 minutes after standing up, the heart rate increases by at least 30 times per minute. In addition, symptoms such as palpitations, dizziness, general weakness, headache, nausea, presyncope, brain fog, and blurred vision may occur. The symptoms last for more than 3 months..
POTS The cause is not very clear, and different patients may have different causes. It is estimated that before the new crown pandemic, the number of people suffering from POTS in the United States was between 500 and 3 million, mainly affecting women of childbearing age and teenagers.
POTS is one of the acute sequelae of COVID-19 infection (PASC). There are also reports that POTS is one of the adverse events of the COVID-19 vaccine.
So what about real data?
The study used data from 284,592 vaccinated participants, with an average age of 52, 57% female, mostly white and 10% Asian. 62% of the vaccines they received were Pfizer's BNT162b2, 31% were Moderna's mRNA-1273, 6.9% were Johnson & Johnson's Ad26.COV2.S, and <0.1%>
data was mainly analyzed in two dimensions. One was to analyze the difference in the probability of being diagnosed with POTS 90 days before and after vaccination, and the other was to analyze the difference in the probability of being diagnosed with POTS and other common primary care diagnosis (CPC) diseases.
Data Analysis Methods and Main Conclusions Data
The five conditions with the highest probability of diagnosis after vaccination were myocarditis , autonomic dysfunction, POTS, mast cell activation syndrome and urinary tract infection (UIT). The probability of being diagnosed with POTS before vaccination was 0.18%, and after vaccination it was 0.27%, with the risk increased by 52%.
The risk of being diagnosed with POTS after vaccination is indeed slightly higher than other diseases, about 10% higher.
Diagnostic probabilities of different diseases after vaccination
Blue indicates POTS-related diseases
The performance of different genders is basically the same. Men have a lower probability of being diagnosed with Ehlers-Danlos syndrome (EDS)
Don’t be scared by the numbers. Next, let’s take a look at the impact of infection with the new coronavirus.
This part of the analysis used 12,460 people with documented COVID-19 infection. The average age was 47 years old, 50% were female, mainly white, and 6% were Asian. The cohort excluded participants who were vaccinated 90 days before or after infection.
Before being infected with the new coronavirus, the probability of being diagnosed with POTS was 0.99%, and after being infected, it was 2.09%, and the risk increased by about 111%.
The characteristics of patients diagnosed with POTS after infection are basically the same as the overall population, except that their age is slightly higher (average 60 years old).
The probability of diagnosis of different diseases after infection with the new coronavirus
The performance of different genders is basically the same. The diagnosis rate of myocarditis is slightly higher in men, but this may be because the number of confirmed cases of myocarditis itself is less (3 cases in men and 2 cases in women)
Comparing the data of the two cohorts, The risk of diagnosis of POTS-related diseases after infection with the new coronavirus is 5.35 times that of diagnosis after vaccination.
In fact, if we look at the confirmed data of other diseases, we can also find that their risks after COVID-19 infection are generally higher than those after vaccination.
Comparison of changes in the probability of disease diagnosis before and after COVID-19 vaccination and COVID-19 infection
What exactly causes the onset of POTS? Previous studies have counted known POTS triggers, and it can be seen that the risk caused by vaccines is still much lower than other factors.
According to the data in the paper on the right, the risk of POTS caused by infection is 683% of that of vaccination.
The risk factors in the right picture from high to low are viral or bacterial infection, surgery, pregnancy, vaccination, puberty, and concussion
Of course, this study also has shortcomings. First, the understanding of POTS and POTS-related diseases itself is relatively lacking, and there may be some problems with diagnostic accuracy. POTS requires symptoms to last for more than 3 months, but the evaluation period of this study is only 90 days, which may lead to an overestimation of the disease diagnosis rate.
Moreover, this study did not take into account the changes in the main circulating strains, and the study population was not general enough.
However, this study still meaningfully points out that POTS and POTS-related diseases are common in COVID-19 vaccination and COVID-19 infection, reminding the importance of more medical protection and vaccination.
Reference:
[1]https://www.nature.com/articles/s44161-022-00177-8
[2]https://www.nature.com/articles/s44161-022-00177-8
[3]https://www.nature.com/articles/s44161-022-00180-z
The author of this article丨Dai Siyu
