This protocol addresses patients with long COVID who report symptoms of postural tachycardia syndrome (POTS). Both non-pharmacological and pharmacological treatments may be considered in this population, with the appropriate approach determined by the patient's hemodynamic status.
Pharmacological management is stratified by hemodynamic phenotype. Agent selection differs across phenotypes — the complete phenotype-based algorithm is available in the full structured protocol.
DOI: 10.3947/ic.2024.0024
When patients with long COVID complain of POTS symptoms, non-pharmacological and pharmacological treatments may be considered depending on their hemodynamic status (G, IIb).
For the tachycardia phenotype, beta-blockers such as ivabradine and metoprolol may be considered, and for the hypotensive phenotype, midodrine, pyridostigmine, and droxidopa may be considered.
For the hyperadrenergic phenotype, clonidine or methyldopa may be considered.
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