NCT06027255

Brief Summary

Parasympathetic nervous system (PNS) is part of the body's autonomic nervous system(PNS) protects body against inflammation. Study shows that reduced PNS function activity is associated with persistent inflammation. Preliminary data from the studies shows, that post-COVID-19 POTS patients have reduced parasympathetic (PNS) function. Given that the PNS protects against inflammation, this clinical trial aims to prove that post-COVID-19 POTS is caused by reduced PNS activity, which in turn, contributes to persistent inflammation, orthostatic intolerance, and OI symptoms. The study will evaluate immune cell activation in post-COVID-19 POTS and patients with history of COVID-19 infection without sequelae and correlate this with the degree of decreased PNS activity.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
150

participants targeted

Target at P75+ for not_applicable

Timeline
14mo left

Started Apr 2024

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress64%
Apr 2024Jul 2027

First Submitted

Initial submission to the registry

August 31, 2023

Completed
7 days until next milestone

First Posted

Study publicly available on registry

September 7, 2023

Completed
8 months until next milestone

Study Start

First participant enrolled

April 24, 2024

Completed
2.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 30, 2026

Expected
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

July 1, 2027

Last Updated

December 15, 2025

Status Verified

December 1, 2025

Enrollment Period

2.2 years

First QC Date

August 31, 2023

Last Update Submit

December 7, 2025

Conditions

Keywords

SARS-CoV-2 infectionPOTSOrthostatic IntoleranceLong COVIDLong hauler COVID infection

Outcome Measures

Primary Outcomes (1)

  • IL-6 levels

    Parasympathetic (PNS) function, protects against inflammation. To Evaluate level of inflammation in post-COVID-19 POTS and patients with history of COVID-19 infection without sequelae and correlate this with the degree of decreased PNS activity. The primary endpoint is IL-6 levels

    Baseline

Secondary Outcomes (2)

  • Orthostatic Symptoms Score

    Baseline

  • cytokines (IL-17, and IFN-ɣ)

    Baseline

Study Arms (3)

Post- COVID 19 POTS patients

OTHER

Inflammatory markers IL-6,Cytokines (IL-17, and IFN-ɣ), Autonomic symptoms assessment questionnaire (COMPASS 31): In post-COVID-19 POTS (cases).

Diagnostic Test: IL-6Diagnostic Test: cytokines (IL-17, and IFN-ɣ)Behavioral: Compass 31

POTS patients

OTHER

Inflammatory markers IL-6,Cytokines (IL-17, and IFN-ɣ), Autonomic symptoms assessment questionnaire (COMPASS 31):Gender, age, and BMI-matched: patients with diagnosis of POTS

Diagnostic Test: IL-6Diagnostic Test: cytokines (IL-17, and IFN-ɣ)Behavioral: Compass 31

Post- COVID 19 POTS patients with Controls

OTHER

Inflammatory markers IL-6,Cytokines (IL-17, and IFN-ɣ), Autonomic symptoms assessment questionnaire (COMPASS 31):Gender, age, and BMI-matched: Controls are :COVID-19 infected without sequelae

Diagnostic Test: IL-6Diagnostic Test: cytokines (IL-17, and IFN-ɣ)Behavioral: Compass 31

Interventions

IL-6DIAGNOSTIC_TEST

Compare IL-6 level , as a marker of inflammation in all the 3 groups: * POTS patients * post-COVID-19 POTS * gender, age, and BMI-matched controls, with history of COVID-19 infection without sequelae.

POTS patientsPost- COVID 19 POTS patientsPost- COVID 19 POTS patients with Controls
Compass 31BEHAVIORAL

Autonomic symptoms assessment questionnaire (COMPASS 31), in post-COVID-19 POTS and compare with POTS patients

POTS patientsPost- COVID 19 POTS patientsPost- COVID 19 POTS patients with Controls

Compare Proinflammatory cells and its secreted cytokines (IL-17, and IFN-ɣ) in all the 3 groups: * POTS patients * post-COVID-19 POTS * gender, age, and BMI-matched controls, with history of COVID-19 infection without sequelae

POTS patientsPost- COVID 19 POTS patientsPost- COVID 19 POTS patients with Controls

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Subjects will be 18 years or older, men and women.
  • History of confirmed COVID-19 infection (positive contact and symptoms, antigen test or PCR).
  • POTS will be defined as the presence of orthostatic tachycardia (\>30 bpm) and chronic (\>3 months) pre-syncopal symptoms.
  • Post-COVID-19 POTS will be defined as the presence of orthostatic tachycardia (\>30 bpm) and chronic (\>3 months) pre-syncopal symptoms. Symptoms occurred within 2 months after COVID infection and persistent until enrollment in the study.

You may not qualify if:

  • Individuals with a history of physician diagnosed myocardial infarction, angina, heart failure, stroke, or transient ischemic attack, or who had undergone an invasive procedure for CVD (coronary artery bypass graft, angioplasty, valve replacement, pacemaker placement or other vascular surgeries).
  • Inability to comply with the protocol, e.g. uncooperative attitude, inability to return for follow-up visits, and unlikelihood of completing the study.
  • Chronic use of steroids, anti-IL6 (omalizumab), anti-TNF-alpha, other immunosuppressants.
  • Chronic use of NSAID. Should not enroll if taking without one week prior to blood sampling.
  • Treatment with plasmapheresis, IVIG or other immune modulator

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Cyndya Shibao

Nashville, Tennessee, 37027, United States

RECRUITING

MeSH Terms

Conditions

Post-Acute COVID-19 SyndromePostural Orthostatic Tachycardia SyndromePrimary DysautonomiasCOVID-19Orthostatic Intolerance

Condition Hierarchy (Ancestors)

Pneumonia, ViralPneumoniaRespiratory Tract InfectionsInfectionsVirus DiseasesCoronavirus InfectionsCoronaviridae InfectionsNidovirales InfectionsRNA Virus InfectionsLung DiseasesRespiratory Tract DiseasesPost-Infectious DisordersChronic DiseaseDisease AttributesPathologic ProcessesPathological Conditions, Signs and SymptomsAutonomic Nervous System DiseasesNervous System DiseasesNeurologic ManifestationsSigns and Symptoms

Central Study Contacts

Marwa Mohamed, Phd

CONTACT

Cyndya Shibao, MD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
DIAGNOSTIC
Intervention Model
PARALLEL
Model Details: To enroll up to 150 patients, 50 POTS without Long-COVID, 50 POTS with Long-COVID and 50 controls with history of COVID-19 infection without sequelae
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor

Study Record Dates

First Submitted

August 31, 2023

First Posted

September 7, 2023

Study Start

April 24, 2024

Primary Completion (Estimated)

June 30, 2026

Study Completion (Estimated)

July 1, 2027

Last Updated

December 15, 2025

Record last verified: 2025-12

Locations