LAUSR

Beta blockers and vaccines show strong efficacy in improving symptoms of suspected post-COVID AD. Introduction SARS-CoV-2 infection, which causes the disease COVID-19, is most known for its severe respiratory complications. However, a variety of extrapulmonary effects have since been described, with cardiovascular complications being among the most common. Those who recover from the acute phase of COVID-19 may be left with residual symptoms such as chest pain and dyspnea, resulting in a decreased quality of life and a syndrome sometimes described as “long COVID.” Recent evidence suggests that survivors with some of these chronic symptoms may have autonomic dysfunction (AD) with features of postural orthostatic tachycardia syndrome (POTS) and/or inappropriate sinus tachycardia (IST). POTS is characterized by symptoms that occur with standing, an increase in heart rate of 30 beats per minute (bpm) (or heart rate.120 bpm) when moving from a supine to a standing position, and the absence of orthostatic hypotension. IST is defined as a sinus heart rate .100 bpm at rest without an identifiable cause of sinus tachycardia. Cardiac manifestations of AD lie on a wide spectrum and can therefore be classified as either POTS, IST, or other unspecified symptoms such as tachycardia and palpitations without a clear, single underlying pathologic mechanism. The treatment of these arrhythmias includes nonpharmacologic management, such as increasing salt and fluid intake, as well as the use of oral medications. Beta blockers or off-label use of ivabradine have been reported to be used in both syndromes with the goal of controlling heart rate to reduce the symptoms. Other