The last point is particularly poignant and clinically relevant, as it provides compelling evidence that can be referenced during physicianpatient encounters in support of vaccination and against vaccine hesitancy. (2021). The study, published in Nature Cardiovascular Research, analyzed electronic health records (EHR) data for outpatient encounters by nearly 285000 individuals whod received COVID-19 vaccines93% of them an mRNA vaccineat Cedars Sinai Medical Center in Los Angeles. Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA, Dysautonomia Clinic, Williamsville, NY, USA, Department of Cardiology, Karolinska University Hospital, and Department of Medicine, Karolinska Institute, Stockholm, Sweden, You can also search for this author in Svetlana Blitshteyn. (accessed May 01, 2023). (2019). This could include damage from excess inflammation as your body fights the infection. 2023 American Medical Association. Im really excited this paper came out, Chung, who wasnt involved in the study, said in an interview. Blitshteyn, S. Eur. If you have POTS and contract COVID-19, you should work with your doctor to manage your symptoms while you recover, says Chung. official website and that any information you provide is encrypted POTS and COVID: Symptoms and Side Effects First, it undeniably establishes POTS and dysautonomia in general as adverse events after vaccination that should be recognized and investigated as other well-accepted post-vaccination syndromes, such as GuillainBarre syndrome and acute disseminated encephalomyelitis. Six to eight months after COVID-19, 17 people (85%) still reported some lingering symptoms. JAMA. And many people with long COVID develop a condition called postural orthostatic tachycardia syndrome, or POTS.. Medical term: Experts use "long COVID" as an umbrella term for health conditions that last at least 12 weeks after a SARS-COV-2 infection. Guillain- Barr Syndrome Associated with COVID-19 Vaccination However, many felt as if their symptoms had improved with treatment, which included at-home care, medications, or both. As Chung pointed out, some people have developed Guillain-Barr syndrome (GBS), a rare neurological disorder, after receiving a flu shot, but research suggests that the odds of GBS are greater after an influenza infection. Similar results were obtained after sex stratification, except that EDS was reported rarely among men (five cases) compared to women (35 cases). Chen, G. et al. The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical. Int J Med Sci. This might include a temporary dosage increase for certain medications, as well as dietary adjustments.. Front Immunol. To assess the validity of their approach, he and his coauthors clinically adjudicated 50 sequentially encountered patients identified as having both unspecified cardiac arrythmia and unspecified disorder of the autonomic nervous system. Continued studies is the the only way to get down to the truth and find treatments that work. Cardiorespiratory responses from supine to head-up tilt. 66, 744754 (2018). After Months Of A Racing Heart And Burning Feet, A COVID Long-Hauler We are being very careful with regard to diagnosing our patients with POTS, as we know COVID-19 can cause blood clots or scars in the lungs, which can cause similar symptoms as POTS but would require very different treatment, explains Chung. Postural orthostatic tachycardia syndrome (POTS) appears to be a component of the emerging "long COVID" phenomenon in some people following even mild SARS-CoV-2 infection, new findings from Cleveland Clinic's Neurological Institute suggest. Long COVID affects 1 in 13 adults in the US, according to the most recent statistics from the Centers for Disease Control and Prevention (CDC). A larger number of people, 9% to 61%, may have POTS-like symptoms that usually occur when moving to an upright position. Article -, Raj S.R. Dec. 13, 2022 - A rare and debilitating heart condition known as postural orthostatic tachycardia syndrome, or POTS, was one of the first post-COVID health disorders that puzzled doctors. analyse site usage and support us in providing free open access scientific content. Coronavirus Symptoms: Frequently Asked Questions, Spiking pulse rate with minimal or mild physical activity. eCollection 2022 Nov. See this image and copyright information in PMC. In the USA, the pre-pandemic prevalence of POTS has been estimated to be in the range of 500,0003,000,000 people, affecting predominantly women of reproductive age and roughly 1 in 100 teenagers3. Our team has developed treatment protocols for children and adults with POTS to help you effectively manage your symptoms and have more control over this disabling and unpredictable condition. Thus, there exists a biological probability of comparable systemic immune responses to COVID-19 vaccinations in comparison to those induced due to SARS-CoV-2 exposure. For COVID-19-vaccinated individuals, POTS odds were higher 90days post-vaccination compared to those 90days prior to vaccination. The study cohort individuals were identified from the Cedars-Sinai health system of Los Angeles County between 2020 and 2022. A rare condition called multisystem inflammatory syndrome in children, or MIS-C, that affects multiple organs can follow COVID-19. COVID-19 and POTS: What You Should Know - WebMD J. Neurol. The main message here is that while we see a potential link between COVID-19 vaccination and POTS, preventing COVID-19 through vaccination is still the best way to reduce your risk of developing POTS, said study author Alan C. Kwan, M.D., through a Cedars-Sinai Medical Center news release. Current research shows that its still possible to have lingering POTS symptoms several months after COVID-19. POTS has been associated with COVID-19. The editorialists noted that the reliability of POTS incidence data depends on awareness and diagnostic vigilance of the condition. The risks of POTS after COVID-19 vaccination and SARS-CoV-2 infection: its worth a shot, https://doi.org/10.1038/s44161-022-00180-z. tachycardia syndrome (POTS) (Figure 1). It really confirms my long suspicion.. examined the frequency of new POTS-associated diagnoses POTS, dysautonomia, fatigue, mast cell disorders and EhlersDanlos syndrome before and after COVID-19-vaccination12. If you want more research into post-infectious illnesses, then linking an infectious event to dozens of serious illnesses can only help. For months noone new what was wrong and would roll thier eyes wheb I mention Pfizer. Methods: We retrospectively reviewed medical records for patients who presented with persistent neurologic and cardiovascular complaints between April and . One of the earlier discoveries with long Covid was that it could be associated with POTS and this new research builds on that, said lead study author Dr. Alan Kwan, a cardiologist at Cedars-Sinai Medical Center. Mar, P. L. & Raj, S. R. Annu Rev Med. Additionally, POTS odds (1.3, n=4,526) were higher than CPC diagnoses odds (1.2, n=33,590) but lower than those for new POTS diagnoses post-COVID-19. J. Intern. These scenarios include patients who begin having POTS symptoms during the acute phase of COVID-19, and patients who don't present with POTS symptoms until weeks after the acute phase. The risks of POTS after COVID-19 vaccination and SARS-CoV-2 infection: its worth a shot. Am. The COVID-19 pandemic has created a unique research opportunity for physicians interested in POTS. A heart rate increase of at least 30 beats per minute, coupled with a drop in blood pressure of no more than 20 mm Hg, is characteristic of POTS. That suggests that some of the people diagnosed with POTS or related diagnoses in the 90 days following vaccination might have been misdiagnosed and recovered later, leading to an overestimation of cases. I've had tinnitus along with digestive issues since the jab. Frequently asked questions about COVID-19 and POTS, 24-hour blood pressure and heart rate monitoring, ncbi.nlm.nih.gov/pmc/articles/PMC8009458/, frontiersin.org/articles/10.3389/fcvm.2022.860198/full, link.springer.com/article/10.1007/s10286-022-00880-3, ncbi.nlm.nih.gov/pmc/articles/PMC9196071/, journals.sagepub.com/doi/abs/10.1177/00099228221113609, cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html, ncbi.nlm.nih.gov/pmc/articles/PMC9287587/, cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/overview-COVID-19-vaccines.html, academic.oup.com/ehjcr/article/5/12/ytab325/6488524, cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html, nhs.uk/conditions/postural-tachycardia-syndrome/, Worried About Long COVID? This article takes a look at the connection between POTS and COVID-19, along with the symptoms, causes, and treatment of POTS. The risks of POTS after COVID-19 vaccination and SARS-CoV-2 infection And to account for the possibility of increased engagement with the health care system after vaccination, they compared the incidence of POTS-related diagnoses with the incidence of common primary care diagnoses that arent POTS related, such as urinary tract infections and gastroesophageal reflux disease. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Is there an association between COVID-19 and the risk of developing an autoimmune disease? This similarity in symptoms led doctors to start testing patients for POTS. Long COVID or post-COVID conditions. We use cookies to enhance your experience. I think POTS is one of the conditions thats been so misunderstood by a lot of doctors, in part because it predominantly affects young women, Chung said. Eldokla, A. M. & Numan, M. T. Clin Auton. Lancet Respir. and JavaScript. Heart Rhythm. The study is of major importance to POTS research and patient care, neurologist Svetlana Blitshteyn, MD, a clinical associate professor at the University of Buffalos Jacobs School of Medicine and Biomedical Sciences, and Karolinska Institute cardiologist Artur Fedorowski, MD, PhD, wrote in an accompanying editorial. Like flu vaccines, COVID-19 vaccines have protected countless individuals from sickness and death, so Chung said, even if I thought there was maybe a causal relationship [with POTS], Im not going to say dont get the vaccine., Published Online: January 25, 2023. doi:10.1001/jama.2023.0050. In a recent study published in Nature Cardiovascular Research, researchers assessed the association between POTS (postural orthostatic tachycardia syndrome) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and coronavirus disease 2019 (COVID-19) vaccinations. Sometimes, POTS can be managed at home by doing the following: If the above strategies arent effective at improving your symptoms, a doctor may suggest trying a medication. One e A wide range of symptoms. "The risk of this happening is much greater with Covid than it is with the vaccine. Provided by the Springer Nature SharedIt content-sharing initiative, Nature Cardiovascular Research (Nat Cardiovasc Res) The conditions with the highest post-SARS-CoV-2 vaccination odds of new diagnoses were POTS, dysautonomia, myocarditis, urinary tract infections, and mast cell activation syndrome. In an email to JAMA, Jesse Goodman, MD, MPH, called Kwans article provocative but not conclusive. Do ketogenic diets elevate low-density lipoprotein cholesterol levels? Postural Orthostatic Tachycardia Syndrome* / etiology If POTS is confirmed, we generally start aggressive hydration, dietary modifications and certain medications, says Chung. The .gov means its official. FOIA Rev. POTS can be triggered by a variety of conditions, including viral or bacterial infections. More info. Researchers are still determining the cause of these extended symptoms, but some COVID-19 "long-haulers" may actually be dealing with a known condition, called postural orthostatic tachycardia syndrome. Res. (2022). Postural orthostatic tachycardia syndrome is a nervous system-related condition that most commonly affects young women of childbearing age. The main message here is that while we see a potential link between Covid-19 vaccination and POTS, preventing Covid-19 through vaccination is still the best way to reduce your risk of developing POTS, Kwan said. https://www.news-medical.net/news/20221214/What-is-the-relation-between-COVID-19-vaccination-and-new-POTS-related-diagnoses.aspx. Throughout the COVID-19 pandemic, a number of cases describe adults who have developed POTS after having COVID-19. Apparent risks of postural orthostatic tachycardia syndrome diagnoses after COVID-19 vaccination and SARS-Cov-2 Infection, Omicron spike N679K mutation acts as a loss-of-function mutation attenuating SARS-CoV-2 in vitro & in vivo. Dr. Ofer Levy, the director of the Precision Vaccines Program at Boston Childrens Hospital, agreed. Researchers should further explore the immune response to shots, because the better we understand how the adverse events work, the smarter we can become in designing better vaccines in the future, Levy said. In comparison, the odds of a diagnosis not related to POTS were 21% higher after vaccination than before. In total, 686 individuals received POTS-related diagnoses post-COVID-19 and had similar demographic profiles as the overall SARS-CoV-2 infection population. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Among adults in this group, 763 (268 per 100,000) experienced POTS after getting vaccinated compared to 501 (176 per 100,000) before getting vaccinated. See additional information. New POTS diagnoses within 90days of exposure were identified based on the international classification of diseases (ICD)-9,10 codes or phecode grouping and expressed as a rate per 100,000 exposures. Further studies are needed to evaluate prevalence, etiology, and optimal management. Furthermore, developing a screening pathway with genetic testing to identify at-risk individuals with a genetic predisposition toward post-vaccination adverse events is necessary, and would lead to a reduction in serious post-vaccination adverse events and promote public trust and vaccination compliance. Sign up for the Nature Briefing newsletter what matters in science, free to your inbox daily. However, Kwan explained, with a longer assessment period, the connection between vaccination and POTS would become hazier. You are using a browser version with limited support for CSS. 27 year old Austrian pianist Sabine Wukovnig is permanently disabled after taking three COVID-19 vaccines (video source). You should talk to your doctor if you have had COVID-19 and are experiencing ongoing symptoms, including: Your doctor will first try to rule out other complications. Some case reports and case series have reported POTS after the mRNA COVID-19 vaccines. This is despite several case series reported from different countries and two studies that demonstrated an increased signal for POTS and its associated symptom clusters following HPV vaccination, based on data from the World Health Organizations pharmacovigilance database and a meta-analysis of clinical study reports from 24 clinical trials9,10,11. 2022 Aug;122(4):1081-1083. doi: 10.1007/s13760-022-02002-2. For new POTS diagnoses post-COVID-19, 12,460 SARS-CoV-2-infected individuals were analyzed, with an average age of 47.0years, of which 50% were women and 54% were Whites. POTS is most common in women between the ages of 15 and 50. System. 32, 307311 (2022). experts have outlined several different mechanisms. Autonomic Function Recovery and Physical Activity Levels in Post-COVID-19 Young Adults after Immunization: An Observational Follow-Up Case-Control Study. Researchers would consider it a post-COVID condition, Rao said . The cause of POTS is unknown, but there are multiple reports to the National Institutes of Health (NIH) of people developing the condition after receiving the COVID vaccine. Consequently, POTS and POTS-associated conditions may be among the most common adverse events after COVID-19 vaccination. Although many people recover quickly from COVID-19, the disease caused by the coronavirus, others who recover may continue to experience symptoms for months. This past December, however, a large cohort study identified a possible association between COVID-19 vaccination and POTS as well as a much stronger link between SARS-CoV-2 infection and POTS. Still, their age was marginally higher (average age of 60 years, 47% were women, and 59% were Whites). I was diagnosed 9 months ago, 4 hours away from my house, at a large university hospital. Pre Its worth noting that theres a significant overlap between POTS symptoms and long COVID symptoms. Privacy Policy| Its unclear how exactly COVID-19 can lead to POTS. He said its unclear whether POTS associated with COVID-19 vaccination or SARS-CoV-2 infection is different from other POTS cases. Good physicians have to be able to navigate that.. This suggests that those with symptomatic COVID-19 infection were more likely to develop POTS in general, and that the risk of post-infection POTS is much higher than post-vaccination POTS in this cohort12. The CDC lists the medical conditions that are confirmed to be associated with more serious COVID-19 here. -, Johansson M., Sthlberg M., Runold M., Nygren-Bonnier M., Nilsson J., Olshansky B., Bruchfeld J., Fedorowski A. Long-Haul Post-COVID-19 Symptoms Presenting as a Variant of Postural Orthostatic Tachycardia Syndrome: The Swedish Experience. A Case of Postural Orthostatic Tachycardia Syndrome Secondary to the Messenger RNA COVID-19 Vaccine. ABC 7 recently interviewed Cedars-Sinai cardiovascular specialist Alan C. Kwan, MD, an investigator with the Smidt Heart Institute, about a study exploring the link between the COVID-19 vaccine and a debilitating heart condition known as postural orthostatic tachycardia syndrome (POTS). Enter long COVID. No funding was received for this project. POTS is clinically diagnosed on the basis of orthostatic dizziness, pre-syncope, palpitations, and a table tilt test or 10.0-minute standing test demonstrating elevated heart rate when changing. You can learn more about how we ensure our content is accurate and current by reading our. . COVID-19 Vaccination Might Induce Postural Orthostatic - PubMed Indeed, in many of the case series of post-COVID POTS, individuals are younger in age and predominantly female. This could lead to nerve damage that may contribute to POTS. Clustered bootstrapping yielded similar OR values. This site needs JavaScript to work properly. Epub 2023 Jan 30. Reports show that long COVID may be linked with an autonomic disorder called postural orthostatic tachycardia syndrome (POTS). Carlton, a 47-year-old from Magnolia, Delaware, was diagnosed with postural orthostatic tachycardia syndrome (POTS) a condition that affects the body's ability to control its own blood flow . How Covid could trigger a debilitating disorder in the nervous system, published in the journal Nature Cardiovascular Research. An official website of the United States government. Alan C. Kwan, Joseph E. Ebinger, Susan Cheng, Jlia Arany, Victor Bazan, Roger Villuendas, Tetsuya Akaishi, Tamotsu Onodera, Tadashi Ishii, Vah Nafilyan, Charlotte R. Bermingham, James C. Doidge, Shigeru Shibata, Kazuo Kobayashi, Hiromi Rakugi, Anna Irene Vedel Srensen, Lampros Spiliopoulos, Anders Hviid, Hannah E. Davis, Lisa McCorkell, Eric J. Topol, Nature Cardiovascular Research Suspected COVID-19 mRNA Vaccine-Induced Postural Orthostatic Tachycardia Syndrome. Freire APCF, Amin S, Lira FS, Morano AEVA, Pereira T, Coelho-E-Silva MJ, Caseiro A, Christofaro DGD, Dos Santos VR, Jnior OM, Pinho RA, Silva BSA. (2021). Google Scholar. Large Cohort Study Finds Possible Association Between Postural Orthostatic Tachycardia Syndrome and COVID-19 Vaccination but Far Stronger Link With SARS-CoV-2 Infection | Cardiology | JAMA | JAMA Network Kanjwal K, Karabin B, Kanjwal Y, Grubb BP. Logistic regression modeling was performed, and the odds ratios (OR) were calculated. Its also possible for POTS to develop after a traumatic event. They found that the odds of POTS and associated diagnoses were higher in the 90 days after vaccine exposure than the 90 days before exposure, with a relative risk increase of 33%12. A Case of Postural Orthostatic Tachycardia Syndrome Secondary - PubMed In order to counteract this, your brain tells blood vessels to constrict and your heart rate to rise. Alabama woman fears COVID vaccine injury information | 1819 News Management includes noninvasive therapies, behavioral approaches, and pharmacologic regimens. Postural Orthostatic Tachycardia Syndrome: JACC Focus Seminar. Official websites use .gov (2022). The condition has been linked to a number of viral or bacterial infections, including influenza, mononucleosis and Lyme disease. Correspondence to Potential POTS association with COVID-19 vaccination weaker than with Postural orthostatic tachycardiasyndrome: Chadda KR, et al. I hope that this research spurs more research, he emphasized. Only eight people (40%) were able to return to work full- or part-time, while the rest were still unable to return to work. How are Women Emotionally Affected After a Hysterectomy? Using 90 days pre-vaccination as the control period, while a valid approach, cannot, as the authors noted, eliminate confounding by unmeasured factors, wrote Goodman, director of Georgetown Universitys Center on Medical Product Access, Safety and Stewardship. sharing sensitive information, make sure youre on a federal As researchers study links between COVID-19 vaccines and uncommon side effects, they have found a slight increase in the number of people who have experienced postural orthostatic tachycardia syndrome (POTS) following vaccination. Diagnosed with pots earlier this year, this is not some new found side effect, this was reported on back in mid 2021 by those that were vaccine injured and witnesses and statements regarding cases appeared and were reported in front of a congressional panel in Washington. The findings, published in the journal Nature Cardiovascular Research, are in line with earlier reports from physicians that Covid may trigger POTS, a disorder of the autonomic nervous system often characterized by a rapid heart rate, low blood pressure, fainting and lightheadedness. Basically, this means that its more out of shape. The findings from this study, which was partially supported by NHLBI, published in. Nat. Authors . Disclaimer. We report a case of new-onset postural orthostatic tachycardia syndrome in a healthy 46-year-old female after a single dose of the BNT162b2 (Pfizer-BioNTech) SARS-CoV-2 vaccine. Interestingly, in Europe she was diagnosed with a "Post-Vaccine Syndrome". Postural orthostatic tachycardia syndrome (POTS) and other - PubMed Covid-19 Vaccine Safety: Severe Adverse Events Moreover, the traditional POTS diagnostic criteria require symptoms to occur over a duration of at least 3 months that is, at least 90 days which is the assessed period. Similar to previous reviews on GBS associated with COVID-19, we found that both COVID-19 and COVID-19 vaccination mostly cause the classic form of GBS (under the clinical diagnosis classification) and the acute inflammatory demyelinating polyneuropathy subtype (based on electrodiagnostic features) within 2 weeks of infection or vaccination (6 . POTS following other types of infection is not uncommon, Schaffner said. However, experts have outlined several different mechanisms that may contribute to POTS alone or in combination: While more research is necessary, its believed that COVID-19 may contribute to POTS in a few different ways. Conflict of Interest Disclosures: None reported. 2006;6:8499. A .gov website belongs to an official government organization in the United States. The study design could be particularly useful for EHR-type cohorts in which limited data elements could impede controlling for confounders, Sean Coady, MA, a statistician in the National Heart, Lung, and Blood Institute (NHLBI) epidemiology branch, wrote in an email to JAMA. Large Cohort Study Finds Possible Association Between Postural doi: 10.7759/cureus.31006. J. Fedorowski, A. et al. PMC Coll. Kwon, A. et al. Online ahead of print. Both COVID-19 and Vaccination Raise the Risk of POTS PubMedGoogle Scholar. Efficacy and Safety Study of Efgartigimod in Adults With Post-COVID-19 POTS (POTS) A phase 2 randomized, double-blinded, placebo-controlled study to evaluate the efficacy and safety of efgartigimod IV in adult patients with post-COVID-19 postural orthostatic tachycardia syndrome (POTS). Goodman, an infectious disease specialist who formerly served as chief scientist at the US Food and Drug Administration, noted that the incidence of most diagnoses measurednot just those related to POTSoccurred more frequently after vaccination than before, further evidence, perhaps, that people who are unwell might postpone getting vaccinated until they feel better. In patients with POTS after COVID-19, the cause is clear, and researchers will be able to compare these patients with those who recovered fully from the virus. A case of transient POTS following COVID-19 vaccine Acta Neurol Belg. Before (2019). Receive automatic alerts about NHLBI related news and highlights from across the Institute. The study is based on a large series of approximately 300,000 vaccinated individuals from one geographic territory in the USA (Los Angeles County), with 0.27% new post-vaccination POTS diagnoses compared with 0.18% in the pre-vaccination period, giving an odds ratio of 1.52 for post-vaccination POTS diagnoses12. doi: 10.1016/j.jaccas.2021.01.009. Doctors who are not familiar with POTS may dismiss these symptoms as lingering effects of COVID-19 or even psychological symptoms. The approach of using an individual as their own control has significant appeal because it minimizes confounders that arent time-dependent, such as genetics, explained Coady, a program official for one of the studys NHLBI grants. All Rights Reserved. Bryarly M., Phillips L.T., Fu Q., Vernino S., Levine B.D. No. You May Be at Less Risk if Youve Had Omicron Variant, People Who Survive Cancer May Have Increased Heart Disease Risk, avoiding standing for long periods of time, lying down and raising your legs if youre experiencing a POTS episode. Heart palpitations and. (2022, December 14). CAS Theres hope that this cohort of patients will help further research into treatment for all people suffering from POTS. 2021 May 4;13(5):e14837. Many patients spend years trying to get properly diagnosed. Post-acute sequelae of SARS-CoV-2 syndrome presenting as postural orthostatic tachycardia syndrome. significantly higher after a Covid infection. On the Heels of COVID-19: Influx of Patients with POTS Symptoms The table below helps to illustrate this. Considering that the cohorts average age was 52 years and that more than half its members were women, the overall rate of myocarditis also seemed high, Robert Bonow, MD, said in an interview. However, these reports are very rare, and additional research is needed. However, current prevalence is likely significantly higher owing to post-COVID-19 POTS, which can develop as part of the post-acute sequelae of SARS-CoV-2 infection (PASC)4,5. Chanlder, R. E. et al. Third, it reaffirms that POTS occurs at a high rate after SARS-CoV-2 infection and is likely one of the major phenotypes of PASC. The most identifiable POTS symptom is a rapid increase in the heartbeat of more than 30 beats per minute, or a heart rate that exceeds 120 beats per minute, within 10 minutes of standing. Apparent risks of postural orthostatic tachycardia syndrome diagnoses after COVID-19 vaccination and SARS-Cov-2 Infection, Inappropriate sinus tachycardia in post-COVID-19 syndrome, Real-world data on the incidence and risk of GuillainBarr syndrome following SARS-CoV-2 vaccination: a prospective surveillance study, Reports of acute adverse events in mRNA COVID-19 vaccine recipients after the first and second doses in Japan, Risk of death following COVID-19 vaccination or positive SARS-CoV-2 test in young people in England, COVID-19 pandemic and hypertension: an updated report from the Japanese Society of Hypertension project team on COVID-19, A nationwide questionnaire study of post-acute symptoms and health problems after SARS-CoV-2 infection in Denmark, Long COVID: major findings, mechanisms and recommendations, Long-term neurologic outcomes of COVID-19, https://doi.org/10.1038/s44161-022-00177-8.
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