New study shows heart medication could help some COVID-19 long-haulers

Doctors study lingering symptoms in COVID-19 long-hauler patients
Posted at 1:28 PM, Feb 22, 2021

SAN DIEGO, Calif. — A new study out of UC San Diego is offering hope for COVID long haulers. The research suggests some of these cases may be treatable with heart medication.

By some estimates, one out of every 10 COVID survivors gets lingering symptoms that can last months after the infection like chronic fatigue, shortness of breath, and brain fog.

A growing number of doctors believe some of these COVID long haulers are experiencing a condition called POTS, which stands for Postural Orthostatic Tachycardia Syndrome.

“When we started delving a little more in-depth into the long hauler syndrome, what we see is they share many of the features of POTS,” said UCSD cardiologist Dr. Pam Taub.

The Journal of the American College of Cardiology published a study by Dr. Taub and others this week showing a heart drug called ivabradine can help alleviate the symptoms of POTS without significant side effects.

Dr. Taub has been studying POTS for years. The syndrome can be triggered by a viral infection.

When someone with POTS stands up after laying down, their heart rate spikes. That spiking heart rate creates a cascade of effects.

“When you have an elevated heart rate, you get short of breath. Sometimes you have chest pain. You don’t feel well. You're not able to stand up. You're not able to do your usual activities,” Dr. Taub said.

Many POTS patients experience brain fog. “When your heart rate is high, it's really hard to get things done. It's hard to focus. You can think of it as a flight or fight response all the time,” she said.

To be sure, not every long-hauler case is POTS. POTS is most common in young women. Doctors say other lingering symptoms from COVID could be caused by blood clots or scarring in the lungs.

POTS is known to occur after significant infections like mononucleosis or Lyme disease. The prevailing theory, Dr. Taub explained, is that antibodies produced in response to the pathogen go haywire.

“These antibodies attack the regulatory systems of the body,” she said, specifically the systems that regulate blood pressure and heart rate.

The study in the Journal of the American College of Cardiology examined 22 patients with POTS. It was the first randomized controlled trial to evaluate the effects of ivabradine.

The study found the drug reduced their spiking heart rate and improved their symptoms and overall quality of life within one month.

Ivabradine is FDA approved to treat heart failure, which means doctors could do what’s called an “off-label” prescription for long-haul COVID.

“This is something that I have used with patients that are COVID long haulers and many of my colleagues across the country have done the same,” Dr. Taub said. “And now that you have a clinical trial, it's also a little bit easier to appeal to insurance companies to cover the drug.”

Without a prescription, a one-month supply of ivabradine costs about $485, so the study could potentially help patients save hundreds of dollars.

Dr. Taub said she hoped the study would encourage more doctors to try ivabradine with COVID long haulers who have confirmed cases of POTS.

This story was first reported by Derek Staahl at KGTV.