Long Covid Blue Legs Symptom

Venous Insufficiency and Acrocyanosis in Long Covid: Dysautonomia

Author: University of Leeds
Published: 2023/08/12 - Updated: 2023/08/22
Publication Type: Awareness / Appreciation - Peer-Reviewed: Yes
Contents: Summary - Main - Related Publications

Synopsis: An case of a Long Covid patient's legs turning blue after 10 minutes of standing highlights the need for greater awareness of this symptom. The paper, authored by Dr Manoj Sivan at the University of Leeds, focuses on the case of one 33-year man who developed with acrocyanosis - venous pooling of blood in the legs. The patient said he had started to experience the discoloration since his COVID-19 infection. He was diagnosed with postural orthostatic tachycardia syndrome (POTS), a condition that causes an abnormal increase in heart rate on standing.

Main Digest

"Venous Insufficiency and Acrocyanosis in Long Covid: Dysautonomia" - The Lancet.

An unusual case of a Long Covid patient's legs turning blue after 10 minutes of standing highlights the need for greater awareness of this symptom among people with the condition, according to new research published in the Lancet.

The paper, authored by Dr Manoj Sivan at the University of Leeds, focuses on the case of one 33-year man who developed with acrocyanosis - venous pooling of blood in the legs (Fig. 1).

2 minutes after standing, the patient's legs began to redden (Fig. 2) and became increasingly blue over time, with veins becoming more prominent. After 10 minutes the color was much more pronounced (Fig. 3), with the patient describing a heavy, itchy sensation in his legs. His original color returned two minutes after he returned to a non-standing position.

Continued below image.
Fig 1. Patient standing at 0 minutes - Image Credit: University of Leeds.
Fig 1. Patient standing at 0 minutes - Image Credit: University of Leeds.
Continued...
Continued below image.
Fig 2. Patient standing at 2 minutes - Image Credit: University of Leeds.
Fig 2. Patient standing at 2 minutes - Image Credit: University of Leeds.
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Continued below image.
Fig 3. Patient standing at 10 minutes - Image Credit: University of Leeds.
Fig 3. Patient standing at 10 minutes - Image Credit: University of Leeds.
Continued...

The patient said he had started to experience the discoloration since his COVID-19 infection. He was diagnosed with postural orthostatic tachycardia syndrome (POTS), a condition that causes an abnormal increase in heart rate on standing.

Dr Sivan, Associate Clinical Professor and Honorary Consultant in Rehabilitation Medicine in the University of Leeds' School of Medicine, said:

"This was a striking case of acrocyanosis in a patient who had not experienced it before his COVID-19 infection."

"Patients experiencing this may not be aware that it can be a symptom of Long Covid and dysautonomia and may feel concerned about what they are seeing. Similarly, clinicians may not be aware of the link between acrocyanosis and Long Covid."

"We need to ensure that there is more awareness of dysautonomia in Long Covid so that clinicians have the tools they need to manage patients appropriately."

Long Covid affects multiple systems in the body and has an array of symptoms, affecting patients' ability to perform daily activities. The condition also affects the autonomic nervous system, which is responsible for regulating blood pressure and heart rate.

Acrocyanosis has previously been observed in children with dysfunction of the autonomic nervous system (dysautonomia), a common symptom of post-viral syndromes.

Previous research by Dr Sivan's team has shown that both dysautonomia and POTS frequently develop in people with Long Covid.

Dysautonomia is also seen in a number of other long-term conditions such as Fibromyalgia and Myalgic Encephalomyelitis, also known as Chronic Fatigue Syndrome or ME.

Dr Sivan said:

"We need more awareness about dysautonomia in long term conditions; more effective assessment and management approaches, and further research into the syndrome. This will enable both patients and clinicians to better manage these conditions."

The research is the latest work by the team in the field of autonomic medicine. Other developments include a home test for people with symptoms of autonomic dysfunction in conditions such as long COVID, chronic fatigue syndrome, fibromyalgia, and diabetes 1 and 2, where people experience dizziness or blackouts.

University of Leeds

The University of Leeds is one of the largest higher education institutions in the UK, with more than 38,000 students from more than 150 different countries. We are renowned globally for the quality of our teaching and research. We are a values-driven university, and we harness our expertise in research and education to help shape a better future for humanity, working through collaboration to tackle inequalities, achieve societal impact and drive change. The University is a member of the Russell Group of research-intensive universities, and plays a significant role in the Turing, Rosalind Franklin and Royce Institutes.

Attribution/Source(s):

This peer reviewed publication pertaining to our Coronavirus Information section was selected for circulation by the editors of Disabled World due to its likely interest to our disability community readers. Though the content may have been edited for style, clarity, or length, the article "Long Covid Blue Legs Symptom" was originally written by University of Leeds, and submitted for publishing on 2023/08/12 (Edit Update: 2023/08/22). Should you require further information or clarification, University of Leeds can be contacted at the leeds.ac.uk website. Disabled World makes no warranties or representations in connection therewith.

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