Neuro-threat Circuity in POTS and PASC: Distinct or More of the Same?

Introduction: The overarching question is whether post-acute sequelae of SARS-CoV-2 (PASC) and non-COVID-related Postural Tachycardia Syndrome (POTS) share overlapping pathophysiological mechanisms, given that reports of both conditions are on the rise and that common mechanisms could open the door to a unified treatment approach.

Objective: This study seeks to understand comorbidities, periaqueductal gray region resting connectivity, and cardiovagal modulation's relationship to inflammation in a population of adolescents with PASC and non-COVID-related POTS.

Methods: In this study, we leverage existing and new data collected from adolescents in the primary RECOVER protocol and a related sub-study (n=40), and compare it with newly collected data from adolescents with non-COVID-related POTS (n=20). We will map the chronology of comorbidities (symptoms/syndromes, infectious history, and history of adverse childhood events) to determine how these are temporally related to onset of PASC and onset of POTS (Aim 1); we will compare MRI data with periaqueductal gray (PAG) region resting connectivity in the PASC, COVID-recovered, and non-COVID-related POTS participants (Aim 2); and, we will assess the relationship of cardiovagal modulation (as assessed by heart rate variability - HRV) to neuroinflammation (brain Myo-inositol derived from neuroimaging) and systemic inflammation (CRP and IL-6) (Aim 3).

Results: Pending.

Conclusion/Discussion: Pending.

Key Topics:

• Comparative studies of Long COVID with other post-viral and post-infectious syndromes
• Long COVID and other chronic conditions,Long-term follow-up of the RECOVER Cohorts