Research suggests that COVID-19 can have a long-term effect on your autonomic nervous system, resulting in dysautonomias like POTS. It’s unclear how long symptoms may persist.

Scientists have made significant strides in preventing and treating acute COVID-19 in the past few years. However, we still know relatively little about the long-term effects of the disease.

Post-acute COVID syndrome (PACS) is a condition that affects some people who develop COVID-19. More commonly known as long COVID, it has links to symptoms of dysautonomia, such as dizziness, a fast heartbeat, and brain fog.

This article explores the connection between COVID-19 and dysautonomia.

Your autonomic nervous system (ANS) is responsible for spontaneous bodily functions such as body temperature, blood pressure, heart rate, and breathing. You don’t have to think about doing these things because your ANS does them automatically.

But COVID-19 could cause your ANS to malfunction, a condition known as dysautonomia. According to a 2022 study of 320 individuals with long COVID, approximately 77% reported dysautonomia symptoms. The authors concluded that dysautonomia is common among people with long COVID.

Studies published in 2021 and 2022 also suggest that dysautonomia might explain symptoms linked to long COVID.

Researchers are trying to understand why some people develop dysautonomia after developing COVID-19 disease. The authors of a 2023 review propose that SARS-CoV-2, the virus that causes COVID-19, triggers chronic inflammation, which damages neurons and impairs ANS function.

Dysautonomia can affect many systems throughout the body, resulting in various symptoms. Some of the most commonly reported conditions are:

  • Postural orthostatic tachycardia syndrome (POTS): POTS causes a fast heart rate, dizziness, and blurred vision when you stand up after lying down. It’s also associated with brain fog, headaches, and fatigue.
  • Inappropriate sinus tachycardia (IST): IST occurs when your heart beats too fast for no apparent reason. Some people also experience dizziness, heart palpitations, and shortness of breath.
  • Neurocardiogenic syncope (NCS): Also known as vasovagal syncope, NCS refers to fainting. It’s caused by a sudden onset of low blood pressure that temporarily deprives your brain of oxygen. Many people experience NCS after a physical or emotional trigger.
  • Orthostatic hypotension: Orthostatic hypotension causes a significant drop in blood pressure when you get up after lying down. If your blood pressure is too low, you might feel dizzy or even lose consciousness.

Your doctor will ask about your symptoms and medical history. They’ll do a physical exam, including tests of your vital signs.

If your doctor suspects dysautonomia or another condition, they’ll do additional tests. Some of these might include:

  • Laboratory tests: Blood and urine analyses provide a better picture of your overall health.
  • Tilt-table test: This test measures changes in your heart rate and blood pressure after you change position. Doctors use it to diagnose POTS.
  • COMPASS-31 questionnaire: The Composite Autonomic Symptom Scale (COMPASS-31) is a survey that screens for dysautonomia.
  • Electrocardiogram (ECG): An ECG allows your doctor to assess heartbeat irregularities.

There is no single treatment for COVID-related dysautonomia. It depends on your symptoms and how severe they are.

For mild symptoms, a doctor might recommend:

For symptoms that are severe or won’t go away, medication can usually help. Some drugs for dysautonomia include:

It’s unclear how long COVID-related dysautonomia symptoms last. The illness varies from one person to the next based on factors such as age and overall health.

According to the World Health Organization, long COVID symptoms appear within 3 months of the initial infection and last at least 2 months.

Other sources, specifically the Centers for Disease Control and Prevention (CDC), say the timeline of symptoms associated with long COVID can vary from months to years.

If you have dysautonomia symptoms caused by long COVID, you might be wondering the following.

How common is dysautonomia after COVID-19?

It’s unclear how many people develop dysautonomia after having COVID-19. A 2022 review cites studies that suggest dysautonomia is present in about 2.5% of people who develop COVID-19. That number rises to 25% in people with a more severe infection or required hospitalization for COVID-19.

Does dysautonomia after COVID-19 go away?

According to the CDC, long COVID symptoms often improve with time. In some cases, though, they can lead to long-term disability. This is more likely in people who were severely affected by COVID-19.

But it’s unclear how long dysautonomia symptoms after COVID-19 may persist. One 2023 review notes that while long COVID symptoms may go away within months to a few years, dysautonomia may be lifelong.

Can the COVID-19 vaccine cause dysautonomia?

The authors of a 2022 cohort study found a possible link between COVID-19 vaccination and POTS. However, the authors also reported a more significant association between SARS-CoV-2 infection and POTS.

People with long COVID often report symptoms such as heartbeat irregularities, dizziness, and fatigue.

These symptoms can indicate a dysautonomia syndrome, such as POTS, IST, NCS, or orthostatic hypotension.

If you are experiencing signs and symptoms of COVID-related dysautonomia, consult a healthcare professional.