Can a heart failure drug help treat long Covid symptoms?

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SOME people who have recovered from Covid-19 experience ongoing symptoms — such as brain fog, increased heart rate, and chronic fatigue —sometimes known as long Covid.

There is an overlap between the symptoms of long Covid and postural orthostatic tachycardia syndrome (POTS), which has led some researchers to suggest they are related.

A small clinical trial suggests that ivabradine, a drug approved for use in heart failure, may be an effective treatment for POTS, with fewer side effects than existing treatments.

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An estimated 1–3 million people in the United States have POTS, which causes tachycardia — a rapid heart rate of more than 100 beats per minute — when a person stands up.
The condition predominantly affects females between the ages of 15 and 50, but males can develop it as well.

Patients are often fit and active before they develop POTS. At its worst, the condition can be debilitating and life changing.

POTS affects the body’s autonomic nervous system, which exerts involuntary control over bodily functions, such as heart rate, blood pressure, sweating, and temperature.

Its causes are poorly understood, but the condition often follows a viral infection, trauma, major surgery, or pregnancy.

There is a distinct overlap between the common symptoms of long Covid and POTS. This has led some researchers to propose that the new coronavirus, which can affect the central nervous system, may trigger POTS in some people.

While the Food and Drug Administration (FDA) have not approved any treatments for POTS, doctors often prescribe beta-blockers to patients with POTS to lower their heart rate.

The drugs reduce activity in the sympathetic nervous system, which is the wing of the autonomic nervous system that reacts to perceived threats with fight-or-flight responses, such as increased heart rate. However, a drawback of beta-blockers is that they not only reduce heart rate but also lower blood pressure, which can exacerbate patients’ fatigue and lack of energy.

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