Abstract Background: Limited studies exist on autonomic dysfunc-tion associated with long-COVID. The most common are or-thostatic intolerance (OI) and postural orthostatic tachycardia syndrome (POTS). Aim of Study: To evaluate autonomic dysfunction as POTS & OH in children 12 months after previous COVID 19 infectionat the cardiology unit, children's hospital, Ain Shams University. Patients and Methods: This was a cross-sectional study that included 25 children aged from six to sixteen years who had a history of past COVID infection. They were subjected to tilt table test the period from June to November 2023. Their-clinical data were collected, includingtheir anthropometric measures, vital data, echocardiography, covid serology and tilt table test results. Results: Our patients included males (68.0%) compared to females (32.0%). Tachycardia was evident in 20% of the pa-tients indicating an abnormally elevated heart rate of more than 40 bpm in response to change in position from supine to incline. None of the patients exhibited abnormal significant decreases in systolic or diastolic blood pressure. Meanwhile, there was a significant change in heart rate in relation to the systolic and the diastolic blood pressure, p-value was 0.026 and 0.000 re-spectively. Conclusion: Postural Orthostatic Tachycardia Syndrome appears to be associated with Post COVID-19 syndrome.