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Auton Neurosci . Pooled rates and demographics of POTS following SARS-CoV-2 infection versus COVID-19 vaccination: Systematic review and meta-analy

tetano

Editor, Senior Moderator
Auton Neurosci


. 2023 Nov 23:250:103132.
doi: 10.1016/j.autneu.2023.103132. Online ahead of print. Pooled rates and demographics of POTS following SARS-CoV-2 infection versus COVID-19 vaccination: Systematic review and meta-analysis

Shin Jie Yong[SUP] 1 [/SUP], Alice Halim[SUP] 2 [/SUP], Shiliang Liu[SUP] 3 [/SUP], Michael Halim[SUP] 4 [/SUP], Ahmad A Alshehri[SUP] 5 [/SUP], Mohammed A Alshahrani[SUP] 5 [/SUP], Mohammed M Alshahrani[SUP] 5 [/SUP], Amal H Alfaraj[SUP] 6 [/SUP], Lamees M Alburaiky[SUP] 7 [/SUP], Faryal Khamis[SUP] 8 [/SUP], Muzaheed[SUP] 9 [/SUP], Bashayer M AlShehail[SUP] 10 [/SUP], Mubarak Alfaresi[SUP] 11 [/SUP], Reyouf Al Azmi[SUP] 12 [/SUP], Hawra Albayat[SUP] 13 [/SUP], Nawal A Al Kaabi[SUP] 14 [/SUP], Mashael Alhajri[SUP] 15 [/SUP], Kawthar Amur Salim Al Amri[SUP] 16 [/SUP], Jameela Alsalman[SUP] 17 [/SUP], Sarah A Algosaibi[SUP] 18 [/SUP], Mona A Al Fares[SUP] 19 [/SUP], Taghreed N Almanaa[SUP] 20 [/SUP], Yahya A Almutawif[SUP] 21 [/SUP], Ranjan K Mohapatra[SUP] 22 [/SUP], Ali A Rabaan[SUP] 23 [/SUP]



Affiliations
Abstract

Purpose: To address recent concerns of postural orthostatic tachycardia syndrome (POTS) occurring after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) vaccination.
Methods: We searched PubMed, Web of Science, and Scopus as of 1st June 2023. We performed a systematic review and meta-analysis of pooled POTS rate in SARS-CoV-2-infected and COVID-19-vaccinated groups from epidemiological studies, followed by subgroup analyses by characteristic. Meta-analysis of risk ratio was conducted to compare POTS rate in infected versus uninfected groups. Meta-analysis of demographics was also performed to compare cases of post-infection and post-vaccination POTS from case reports and series.
Results: We estimated the pooled POTS rate of 107.75 (95 % CI: 9.73 to 273.52) and 3.94 (95 % CI: 0 to 16.39) cases per 10,000 (i.e., 1.08 % and 0.039 %) in infected and vaccinated individuals based on 5 and 2 studies, respectively. Meta-regression revealed age as a significant variable influencing 86.2 % variance of the pooled POTS rate in infected population (P < 0.05). Moreover, POTS was 2.12-fold more likely to occur in infected than uninfected individuals (RR = 2.12, 95 % CI: 1.71 to 2.62, P < 0.001). Meta-analyzed demographics for cases of post-infection (n = 43) and post-vaccination (n = 17) POTS found no significant differences in several variables between groups, except that the time from exposure to symptom onset was shorter for cases of post-vaccination POTS (P < 0.05).
Conclusion: Although evidence is limited for post-vaccination POTS, our study showed that POTS occur more frequently following SARS-CoV-2 infection than COVID-19 vaccination.

Keywords: Autonomic disorder; COVID-19 vaccine; Incidence; Postural orthostatic tachycardia syndrome; SARS-CoV-2.

 
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