{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T13:54:14Z","timestamp":1781790854711,"version":"3.54.5"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,6,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Postural orthostatic tachycardia syndrome (POTS) is increasingly recognized after SARS\u2010CoV\u20102 infection. We compared autonomic phenotype, functional impact, and circulating immune markers in POTS, postacute sequelae of COVID\u201019 (PASC), and healthy controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">In this cross\u2010sectional study (August 2021 to December 2022), we recruited patients with POTS (n=24) or PASC (n=24) and healthy controls (n=19). Participants underwent 10\u2010minute active stand testing, 24\u2010hour Holter monitoring, serum cytokine, and adrenergic autoantibody assays (cell\u2010based activation). Patient\u2010reported outcome measures were collected via secure electronic link.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The study included 67 participants (mean age, 32.4\u00b18.9\u2009years; 71% women). Compared with controls and participants with PASC, participants with POTS demonstrated significantly higher orthostatic tachycardia (active stand heart rate change from supine to standing, 46.3\u00b114.0\u2009bpm versus 12.7\u00b16.6\u2009bpm in controls and 34.6\u00b113.7\u2009bpm in PASC;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001; POTS versus PASC\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.005). Among participants with PASC, 62.5% met formal POTS criteria. Cytokine analysis revealed lower interleukin\u20102 and higher interleukin\u20108 levels in POTS versus controls, with POTS cases showing elevated tumor necrosis factor\u2010\u03b1 compared with those without POTS. Autoantibody activation measures did not differ significantly among groups, and multivariate biomarker models lacked predictive utility for POTS diagnosis. Patient\u2010reported outcome measures indicated greater fatigue, orthostatic intolerance, and autonomic symptom burden and reduced health\u2010related quality of life in POTS and PASC groups compared with controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">POTS and PASC exhibit overlapping autonomic symptomology and profound functional impairment. Alterations in cytokines suggest a possible cytokine\u2010linked or compartmentalized immune contribution, but cytokine and autoantibody measures alone do not predict POTS. Routine autonomic assessment in persistent postviral illness and larger longitudinal, multimodal studies are warranted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">Australian New Zealand Clinical Trial Registry; ACTRN: 12621000476831.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.048615","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T10:48:36Z","timestamp":1779706116000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Analysis of Circulating Cytokines and Adrenergic Autoantibodies in Postural Orthostatic Tachycardia Syndrome, Postacute Sequelae of SARS\u2010CoV\u20102, and Healthy Controls"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8430-1489","authenticated-orcid":false,"given":"Marie\u2010Claire","family":"Seeley","sequence":"first","affiliation":[{"name":"Adelaide University","place":["Adelaide, Australia"]},{"name":"South Australian Health and Medical Research Institute","place":["Adelaide, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5114-400X","authenticated-orcid":false,"given":"Celine","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Adelaide University","place":["Adelaide, Australia"]},{"name":"South Australian Health and Medical Research Institute","place":["Adelaide, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9072-2264","authenticated-orcid":false,"given":"Gemma","family":"Wilson","sequence":"additional","affiliation":[{"name":"Adelaide University","place":["Adelaide, Australia"]},{"name":"South Australian Health and Medical Research Institute","place":["Adelaide, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6375-8487","authenticated-orcid":false,"given":"Danielle","family":"Bailey","sequence":"additional","affiliation":[{"name":"Adelaide University","place":["Adelaide, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7644-9863","authenticated-orcid":false,"given":"Amy","family":"Langdon","sequence":"additional","affiliation":[{"name":"Royal Adelaide Hospital","place":["Adelaide, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Ong","sequence":"additional","affiliation":[{"name":"Royal Adelaide Hospital","place":["Adelaide, Australia"]},{"name":"Flinders University","place":["Adelaide, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5257-9929","authenticated-orcid":false,"given":"Jonathan","family":"Chieng","sequence":"additional","affiliation":[{"name":"Adelaide University","place":["Adelaide, Australia"]},{"name":"Royal Adelaide Hospital","place":["Adelaide, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2754-8263","authenticated-orcid":false,"given":"Kristina","family":"Comacchio","sequence":"additional","affiliation":[{"name":"Adelaide University","place":["Adelaide, Australia"]},{"name":"South Australian Health and Medical Research Institute","place":["Adelaide, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7086-5865","authenticated-orcid":false,"given":"Amanda J.","family":"Page","sequence":"additional","affiliation":[{"name":"Adelaide University","place":["Adelaide, Australia"]},{"name":"South Australian Health and Medical Research Institute","place":["Adelaide, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0701-271X","authenticated-orcid":false,"given":"Lynsie","family":"Morris","sequence":"additional","affiliation":[{"name":"University of Oklahoma Health Sciences Center","place":["Oklahoma City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Toumpourleka","sequence":"additional","affiliation":[{"name":"University of Oklahoma Health Sciences Center","place":["Oklahoma City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Greg","family":"Matlock","sequence":"additional","affiliation":[{"name":"University of Oklahoma Health Sciences Center","place":["Oklahoma City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Cai","sequence":"additional","affiliation":[{"name":"University of Oklahoma Health Sciences Center","place":["Oklahoma City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xichun","family":"Yu","sequence":"additional","affiliation":[{"name":"University of Oklahoma Health Sciences Center","place":["Oklahoma City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7753-1318","authenticated-orcid":false,"given":"Dennis H.","family":"Lau","sequence":"additional","affiliation":[{"name":"Adelaide University","place":["Adelaide, Australia"]},{"name":"South Australian Health and Medical Research Institute","place":["Adelaide, Australia"]},{"name":"Royal Adelaide Hospital","place":["Adelaide, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4370-8135","authenticated-orcid":false,"given":"Stavros","family":"Stavrakis","sequence":"additional","affiliation":[{"name":"University of Oklahoma Health Sciences Center","place":["Oklahoma City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.autneu.2021.102828"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2025.09.004"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2019.12.024"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-023-00955-9"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.2147\/VHRM.S127393"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-87748-4"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000160356.97313.5D"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10040623"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.24245"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12852"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.52710"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.11.059"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.122.059971"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.113.000755"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12265-021-10167-z"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-014-0981-8"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.013006"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/s44161-022-00177-8"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-023-00842-w"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2023.06.010"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12010073"},{"key":"e_1_3_2_23_2","volume-title":"A Clinical Case Definition of Post Covid\u201019 Condition by a Delphi Consensus, 6 October 2021","author":"Organization WH","year":"2021","unstructured":"Organization WH . 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