{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:20:52Z","timestamp":1787026852700,"version":"build-2736575974"},"reference-count":63,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T00:00:00Z","timestamp":1751846400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Significant clinical similarities have been observed between the recently described \u201cLong-Haul\u201d COVID-19 (LHC) syndrome, Postural Orthostatic Tachycardia Syndrome (POTS) and Inappropriate Sinus Tachycardia (IST). Shared symptoms include light-headedness, palpitations, tremulousness, generalized weakness, blurred vision, chest pain, dyspnea, \u201cbrain-fog,\u201d and fatigue. Ivabradine is a selective sinoatrial node blocker FDA-approved for management of tachycardia associated with stable angina and heart failure not fully managed by beta blockers. In our study we aim to identify risk factors underlying LHC, as well as the effectiveness of ivabradine in controlling heart rate dysregulations and POTS\/IST related symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods\/design<\/jats:title>\n                    <jats:p>A detailed prospective phenotypic evaluation combined with multi-omic analysis of 200 LHC volunteers will be conducted to identify risk factors for autonomic dysfunction. A comparator group of 50 volunteers with documented COVID-19 but without LHC will be enrolled to better understand the risk factors for LHC and autonomic dysfunction. Those in the cohort who meet diagnostic criteria for POTS or IST will be included in a nested prospective, randomized, placebo-controlled trial to assess the impact of ivabradine on symptoms and heart rate, assessed non-invasively based on physiologic response and ambulatory electrocardiogram. Additionally, studies on catecholamine production, mast cell and basophil degranulation, inflammatory biomarkers, and indicators of metabolic dysfunction will be measured to potentially provide molecular classification and mechanistic insights.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Optimal therapies for dysautonomia, particularly associated with LHC, have yet to be defined. In the present study, ivabradine, one of numerous proposed interventions, will be systematically evaluated for therapeutic potential in LHC-associated POTS and IST. Additionally, this study will further refine the characteristics of the LHC-associated POTS\/IST phenotype, genotype and transcriptional profile, including immunologic and multi-omic analysis of persistent immune activation and dysregulation. The study will also explore and identify potential endotheliopathy and abnormalities of the clotting cascade.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:uri>https:\/\/clinicaltrials.gov\/<\/jats:uri>\n                      , identifier NCT05481177.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1550636","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T11:09:15Z","timestamp":1751886555000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparative cohort study of post-acute COVID-19 infection with a nested, randomized controlled trial of ivabradine for those with postural orthostatic tachycardia syndrome (the COVIVA study)"],"prefix":"10.3389","volume":"16","author":[{"given":"David","family":"Saunders","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas B.","family":"Arnold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason M.","family":"Lavender","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daoqin","family":"Bi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Alcover","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia D.","family":"Hellwig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahar T.","family":"Leazer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roshila","family":"Mohammed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethelhem","family":"Markos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanchana","family":"Perera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dutchabong","family":"Shaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscilla","family":"Kobi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Autumn","family":"Mains","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marian","family":"Tanofsky-Kraff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Goguet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Mitre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen P.","family":"Pratt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clifton L.","family":"Dalgard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark C.","family":"Haigney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,7]]},"reference":[{"key":"ref1","year":""},{"key":"ref2","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1146\/annurev-med-041818-011630","article-title":"Postural orthostatic tachycardia syndrome: mechanisms and new therapies","volume":"71","author":"Mar","year":"2020","journal-title":"Annu Rev Med"},{"key":"ref3","year":""},{"key":"ref4","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1007\/s10286-021-00798-2","article-title":"Long-COVID postural tachycardia syndrome: an American autonomic society statement","volume":"31","author":"Raj","year":"2021","journal-title":"Clin Auton Res"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1607","DOI":"10.1038\/s41591-021-01433-3","article-title":"COVID in a prospective cohort of home-isolated patients","volume":"27","author":"Blomberg","year":"2021","journal-title":"Nat Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2331","DOI":"10.1016\/j.jacc.2022.04.007","article-title":"Autonomic dysfunction as a consequence of COVID-19 infection: a new twist on an old problem","volume":"79","author":"Grubb","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1111\/joim.12852","article-title":"Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management","volume":"285","author":"Fedorowski","year":"2019","journal-title":"J Intern Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e41","DOI":"10.1016\/j.hrthm.2015.03.029","article-title":"2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope","volume":"12","author":"Sheldon","year":"2015","journal-title":"Heart Rhythm"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"100025","DOI":"10.1016\/j.ahjo.2021.100025","article-title":"Post-acute COVID-19 syndrome and the cardiovascular system: what is known?","volume":"5","author":"Dixit","year":"2021","journal-title":"Am Heart J Plus Cardiol Res Pract"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1038\/s41591-021-01283-z","article-title":"Post-acute COVID-19 syndrome","volume":"27","author":"Nalbandian","year":"2021","journal-title":"Nat Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"686029","DOI":"10.3389\/fimmu.2021.686029","article-title":"Unraveling the mystery surrounding post-acute sequelae of COVID-19","volume":"12","author":"Ramakrishnan","year":"2021","journal-title":"Front Immunol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"n1648","DOI":"10.1136\/bmj.n1648","article-title":"Long covid-mechanisms, risk factors, and management","volume":"374","author":"Crook","year":"2021","journal-title":"BMJ"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1016\/j.amjmed.2021.07.004","article-title":"Post-COVID-19 tachycardia syndrome: a distinct phenotype of post-acute COVID-19 syndrome","volume":"134","author":"St\u00e5hlberg","year":"2021","journal-title":"Am J Med"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"2367","DOI":"10.1002\/jnr.24917","article-title":"A role for T-cell exhaustion in long COVID-19 and severe outcomes for several categories of COVID-19 patients","volume":"99","author":"Roe","year":"2021","journal-title":"J Neurosci Res"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e021002","DOI":"10.1161\/JAHA.121.021002","article-title":"Mast cell activation disorder and postural orthostatic tachycardia syndrome: a clinical association","volume":"10","author":"Kohno","year":"2021","journal-title":"J Am Heart Assoc"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1093\/infdis\/jiab174","article-title":"Immunoglobulin G immune complexes may contribute to neutrophil activation in the course of severe coronavirus disease 2019","volume":"224","author":"Mazzitelli","year":"2021","journal-title":"J Infect Dis"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.immuni.2015.01.022","article-title":"Immune complexes: not just an innocent bystander in chronic viral infection","volume":"42","author":"Wang","year":"2015","journal-title":"Immunity"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1007\/s12185-020-03029-y","article-title":"COVID-19-associated coagulopathy and disseminated intravascular coagulation","volume":"113","author":"Asakura","year":"2021","journal-title":"Int J Hematol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1111\/jth.15191","article-title":"The ADAMTS13-von Willebrand factor axis in COVID-19 patients","volume":"19","author":"Mancini","year":"2021","journal-title":"J Thromb Haemost"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1914","DOI":"10.1111\/jth.15409","article-title":"ADAMTS13 regulation of VWF multimer distribution in severe COVID-19","volume":"19","author":"Ward","year":"2021","journal-title":"J Thromb Haemost"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"106975","DOI":"10.1016\/j.vph.2022.106975","article-title":"Endothelial dysfunction in acute and long standing COVID-19: a prospective cohort study","volume":"144","author":"Oikonomou","year":"2022","journal-title":"Vasc Pharmacol"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1101\/2022.01.20.22269321","article-title":"Extreme gammaprime levels in COVID-19 patients","author":"Farrell","year":"2022","journal-title":"MedRxiv"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"2546","DOI":"10.1111\/jth.15490","article-title":"Persistent endotheliopathy in the pathogenesis of long COVID syndrome","volume":"19","author":"Fogarty","year":"2021","journal-title":"J Thromb Haemost"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"3468","DOI":"10.1182\/bloodadvances.2020003346","article-title":"High fibrinogen gamma' levels in patient plasma increase clot formation at arterial and venous shear","volume":"5","author":"Macrae","year":"2021","journal-title":"Blood Adv"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1038\/d41586-020-02598-6","article-title":"The lasting misery of coronavirus long-haulers","volume":"585","author":"Marshall","year":"2020","journal-title":"Nature"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1364","DOI":"10.1111\/anae.15180","article-title":"Resilience strategies to manage psychological distress among healthcare workers during the COVID-19 pandemic: a narrative review","volume":"75","author":"Heath","year":"2020","journal-title":"Anaesthesia"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"3165","DOI":"10.3390\/ijerph17093165","article-title":"Nationwide survey of psychological distress among Italian people during the COVID-19 pandemic: immediate psychological responses and associated factors","volume":"17","author":"Mazza","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1684","DOI":"10.3389\/fpsyg.2020.01684","article-title":"The psychological impact of the COVID-19 outbreak on health professionals: a cross-sectional study","volume":"11","author":"Giusti","year":"2020","journal-title":"Front Psychol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"e0240501","DOI":"10.1371\/journal.pone.0240501","article-title":"Psychological impact of mass quarantine on population during pandemics-the COVID-19 lock-down (COLD) study","volume":"15","author":"Pandey","year":"2020","journal-title":"PLoS One"},{"key":"ref30","volume-title":"The diagnostic and statistical manual of mental disorders, fifth edition (DSM-5)","year":"2013"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"575","DOI":"10.3390\/healthcare9050575","article-title":"Long-COVID syndrome? A study on the persistence of neurological, psychological and physiological symptoms","volume":"9","author":"Orr\u00f9","year":"2021","journal-title":"Healthcare"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1002\/acn3.51350","article-title":"Persistent neurologic symptoms and cognitive dysfunction in non-hospitalized Covid-19 \"long haulers\"","volume":"8","author":"Graham","year":"2021","journal-title":"Ann Clin Transl Neurol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"104621","DOI":"10.1016\/j.micpath.2020.104621","article-title":"ACE2 and TMPRSS2 polymorphisms in various diseases with special reference to its impact on COVID-19 disease","volume":"150","author":"Singh","year":"2021","journal-title":"Microb Pathog"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"878","DOI":"10.1134\/S1022795421080056","article-title":"Genetic risk factors for the development of COVID-19 coronavirus infection","volume":"57","author":"Glotov","year":"2021","journal-title":"Russ J Genet"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"564741","DOI":"10.3389\/fgene.2020.564741","article-title":"Genetic association of ACE2 rs2285666 polymorphism with COVID-19 spatial distribution in India","volume":"11","author":"Srivastava","year":"2020","journal-title":"Front Genet"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"100930","DOI":"10.1016\/j.mgene.2021.100930","article-title":"A variant in TMPRSS2 is associated with decreased disease severity in COVID-19","volume":"25","author":"Ravikanth","year":"2021","journal-title":"Meta Gene"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"819","DOI":"10.17179\/excli2022-4976","article-title":"The association of ACE1, ACE2, TMPRSS2, IFITM3 and VDR polymorphisms with COVID-19 severity: a systematic review and meta-analysis","volume":"21","author":"Dobrijevic","year":"2022","journal-title":"EXCLI J"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"146790","DOI":"10.1016\/j.gene.2022.146790","article-title":"Systematic review and meta-analysis of human genetic variants contributing to COVID-19 susceptibility and severity","volume":"844","author":"Gupta","year":"2022","journal-title":"Gene"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"812940","DOI":"10.3389\/fimmu.2022.812940","article-title":"ACE and ACE2 gene variants are associated with severe outcomes of COVID-19 in men","volume":"13","author":"Mart\u00ednez-G\u00f3mez","year":"2022","journal-title":"Front Immunol"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s40246-021-00330-7","article-title":"Initial study on TMPRSS2 p. Val160Met genetic variant in COVID-19 patients","volume":"15","author":"Wulandari","year":"2021","journal-title":"Hum Genomics"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"e2323","DOI":"10.1002\/rmv.2323","article-title":"Polymorphisms of ACE1, ACE2, and TMPRSS2 associated with COVID-19 severity: a systematic review with meta-analysis","volume":"32","author":"Saengsiwaritt","year":"2022","journal-title":"Rev Med Virol"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1186\/s13054-020-03120-0","article-title":"Role of angiotensin-converting enzyme 2 (ACE2) in COVID-19","volume":"24","author":"Ni","year":"2020","journal-title":"Crit Care"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1456","DOI":"10.1161\/CIRCRESAHA.120.317015","article-title":"Angiotensin-converting enzyme 2: SARS-CoV-2 receptor and regulator of the renin-angiotensin system","volume":"126","author":"Gheblawi","year":"2020","journal-title":"Circ Res"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1473","DOI":"10.1080\/07853890.2022.2076901","article-title":"Pathophysiology and mechanism of long COVID: a comprehensive review","volume":"54","author":"Castanares-Zapatero","year":"2022","journal-title":"Ann Med"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1016\/S2213-2600(22)00127-8","article-title":"Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study","volume":"10","year":"2022","journal-title":"Lancet Respir Med"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"1935","DOI":"10.3390\/genes13111935","article-title":"Genetic association between ACE2 (rs2285666 and rs2074192) and TMPRSS2 (rs12329760 and rs2070788) polymorphisms with post-COVID symptoms in previously hospitalized COVID-19 survivors","volume":"13","author":"Fern\u00e1ndez-de-Las-Pe\u00f1as","year":"2022","journal-title":"Genes (Basel)"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"e67","DOI":"10.1016\/j.jinf.2022.12.026","article-title":"ACE1 rs1799752 polymorphism is not associated with long-COVID symptomatology in previously hospitalized COVID-19 survivors","volume":"86","author":"Fern\u00e1ndez-de-Las- Pe\u00f1as","year":"2023","journal-title":"J Infect"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1161\/HYPERTENSIONAHA.111.172262","article-title":"Exercise training versus propranolol in the treatment of the postural orthostatic tachycardia syndrome","volume":"58","author":"Fu","year":"2011","journal-title":"Hypert Hypert"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1016\/j.cjca.2019.12.024","article-title":"Canadian cardiovascular society position statement on postural orthostatic tachycardia syndrome (POTS) and related disorders of chronic orthostatic intolerance","volume":"36","author":"Raj","year":"2020","journal-title":"Can J Cardiol"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1016\/j.jacc.2020.12.029","article-title":"Randomized trial of Ivabradine in patients with hyperadrenergic postural orthostatic tachycardia syndrome","volume":"77","author":"Taub","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"ref51","volume-title":"User\u2019s manual for the SF-36v2 health survey","author":"Maruish","year":"2011"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1016\/j.genhosppsych.2010.03.006","article-title":"The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review","volume":"32","author":"Kroenke","year":"2010","journal-title":"Gen Hosp Psychiatry"},{"key":"ref53","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1348\/014466505X29657","article-title":"The short-form version of the depression anxiety stress scales (DASS-21): construct validity and normative data in a large non-clinical sample","volume":"44","author":"Henry","year":"2005","journal-title":"Br J Clin Psychol"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.1093\/arclin\/acaa128","article-title":"Normative reference values, reliability, and item-level symptom endorsement for the PROMIS\u00ae v2. 0 cognitive function-short forms 4a, 6a and 8a","volume":"36","author":"Iverson","year":"2021","journal-title":"Arch Clin Neuropsychol"},{"key":"ref55","volume-title":"Structured clinical interview for DSM-5\u2014Research version (SCID-5 for DSM-5, research version; SCID-5-RV)","author":"First","year":"2015"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1017\/S1355617714000241","article-title":"Reliability and validity of composite scores from the NIH toolbox cognition battery in adults","volume":"20","author":"Heaton","year":"2014","journal-title":"J Int Neuropsychol Soc"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1007\/s12026-021-09185-5","article-title":"Postural orthostatic tachycardia syndrome (POTS) and other autonomic disorders after COVID-19 infection: a case series of 20 patients","volume":"69","author":"Blitshteyn","year":"2021","journal-title":"Immunol Res"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"886609","DOI":"10.3389\/fneur.2022.886609","article-title":"Dysautonomia in COVID-19 patients: a narrative review on clinical course, diagnostic and therapeutic strategies","volume":"13","author":"Carmona-Torre","year":"2022","journal-title":"Front Neurol"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"537","DOI":"10.3233\/ADR-200273","article-title":"The vagal autonomic pathway of COVID-19 at the crossroad of Alzheimer\u2019s disease and aging: a review of knowledge","volume":"4","author":"Rangon","year":"2020","journal-title":"J Alzheimers Dis Rep"},{"key":"ref60","doi-asserted-by":"crossref","DOI":"10.21203\/rs.3.rs-122775\/v1","volume-title":"Trajectories of key physiological parameters in COVID-19 patients using continuous remote monitoring and health AI","author":"Eisenkraft","year":""},{"key":"ref61","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.4065\/74.11.1106","article-title":"Postural tachycardia syndrome: clinical features and follow-up study","volume":"74","author":"Sandroni","year":"1999","journal-title":"Mayo Clin Proc"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"1515486","DOI":"10.3389\/fneur.2024.1515486","article-title":"Oral medications for the treatment of postural orthostatic tachycardia syndrome; a systematic review of studies before and during the COVID-19 pandemic","volume":"15","author":"Pierson","year":"2025","journal-title":"Front Neurol"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"647","DOI":"10.3390\/medicina57070647","article-title":"Blinding in clinical trials: seeing the big picture","volume":"57","author":"Monaghan","year":"2021","journal-title":"Medicina"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1550636\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T11:09:23Z","timestamp":1751886563000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1550636\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,7]]},"references-count":63,"alternative-id":["10.3389\/fneur.2025.1550636"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1550636","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2023.04.25.23289110","asserted-by":"object"}]},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,7]]},"article-number":"1550636"}}