Majority of Pediatric Long COVID Patients Develop Orthostatic Intolerance

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A new study from Kennedy Krieger Institute shows that the majority of children diagnosed with long COVID are likely to experience orthostatic intolerance (OI), a condition that causes the body to struggle with regulating blood pressure and heart rate when standing up. As a result, children often feel dizzy, lightheaded, fatigued and may experience “brain fog” or cognitive difficulties.

Orthostatic intolerance includes disorders such as postural orthostatic tachycardia syndrome (POTS) and orthostatic hypotension. Among the patients studied, dizziness (67%), fatigue (25%), and body pain (23%) are found to be common symptoms, which worsen when standing and improve when lying down. These symptoms can make it difficult to perform everyday activities like exercising, attending school, and socializing, severely impacting their quality of life.

This new research, conducted at Kennedy Krieger’s Pediatric Post-COVID-19 Rehabilitation Clinic, reveals that OI is prevalent among children dealing with the long-term effects of the COVID-19 virus. Researchers found 71% of the patients studied at the Institute experienced at least one orthostatic condition.

Dr. Laura Malone, director of the pediatric post-COVID-19 rehabilitation clinic at Kennedy Krieger, is the senior author of this study. She explains these findings show the importance of screening pediatric long COVID patients for OI, as many have symptoms that could be missed without proper testing.

“Research proves this condition is common. Sixty-five out of the 92 children we studied were battling side effects like dizziness and fatigue from OI” Dr. Malone said. “Early diagnosis and treatment will give them the chance to recover and return to their normal routines.”

The study findings call for a multi-faceted approach to treatment. Research emphasizes the importance of increased salt and fluid intake, exercise training, and physical therapy. Medications to manage heart rate and blood pressure are also being explored. However, Dr. Malone says more research is needed to fully understand OI.

“Our goal is to provide more targeted and tailored treatments that will help these children,” Dr. Malone said. “This study is just the beginning, and we hope it will spark further research to support for children with long COVID.”

Reference: 

Morrow AK, Villatoro C, Kokorelis C, Rowe PC, Malone LA. Orthostatic
intolerance in children with long COVID utilizing a 10-minute passive standing
test. Clin Pediatr (Phila). 2024. doi: 10.1177/00099228241272053

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