Increased Diagnosis Rates and Clinical Characteristics of Pediatric Postural Orthostatic Tachycardia Syndrome During...

Area of Science:

• Pediatric Cardiology
• Autonomic Dysfunction
• Epidemiology

Background:

• Postural Orthostatic Tachycardia Syndrome (POTS) is a complex autonomic disorder affecting children and adolescents.
• The Coronavirus Disease 2019 (COVID-19) pandemic may have influenced the incidence and presentation of pediatric POTS.
• Understanding pandemic-related changes in POTS diagnoses is crucial for clinical management.

Purpose of the Study:

• To compare the frequency and clinical characteristics of pediatric POTS diagnoses before and during the COVID-19 pandemic.
• To identify potential contributing factors associated with pandemic-era POTS diagnoses in pediatric patients.
• To assess the impact of lifestyle and psychosocial factors on POTS development during the pandemic.

Main Methods:

• Retrospective analysis of 117 pediatric POTS patients diagnosed between January 2018 and December 2023.
• Comparison of pre-pandemic (n=46) and pandemic (n=71) cohorts.
• Collection and analysis of clinical, laboratory, and psychosocial data; logistic regression for predictor identification.

Main Results:

• Pediatric POTS diagnoses significantly increased during the pandemic (10.5% vs. 6.1%, P=.01).
• Pandemic patients reported decreased physical activity (72%), increased screen time (85%), and higher anxiety (34% vs. 18%, P=.04) and palpitations (P=.03).
• Higher Vitamin B12 levels were noted in the pandemic group (P=.043), with no significant differences in hemoglobin or heart rate variability.

Conclusions:

• The COVID-19 pandemic correlated with a substantial increase in pediatric POTS diagnoses.
• Lifestyle changes (reduced activity, increased screen time) and psychosocial stress appear to be key drivers.
• Early recognition, physical rehabilitation, and psychological support are vital for managing pediatric POTS, especially post-pandemic.