Blue legs syndrome: The latest long COVID symptom

I have a friend who is a “long-hauler.” And it’s not a label she takes pleasure in.

“Long-haulers” are people previously infected with COVID-19 who continue to live with symptoms like fatigue, headaches, brain fog, shortness of breath and heart palpitations.

Recently, yet another troubling symptom has come to the attention of researchers.

It involves a malfunction of the autonomic nervous system.

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You on ‘autopilot’

Have you ever wondered how your heart knows to keep beating? What makes your lungs take in air without consciously thinking about it? Why food digests instead of just sitting like a lump in your stomach?

Well, you can thank your autonomic nervous system for all of that.

The autonomic nervous system controls all the involuntary functions of our body. This includes our blood flow and blood pressure.

When this system malfunctions, it’s known as dysautonomia, a condition that has been known to occur following a viral infection, like mumps, Epstein-Barr and hepatitis C.

So it’s not all that surprising that dysautonomia seems to be behind a strange, new symptom for COVID long-haulers.

“Why are my legs turning blue?”

Doctors at the University of Leeds in England reported the unusual case of a COVID survivor who began showing symptoms of acrocyanosis, a painless, bluish discoloration of hands or feet caused by spasms of small blood vessels.

Dr. Manoj Sivan, Associate Clinical Professor and Honorary Consultant in Rehabilitation Medicine in the University of Leeds’ School of Medicine, calls this “a striking case of acrocyanosis in a patient who had not experienced it before his COVID-19 infection.”

A minute after standing, the man’s legs began to redden and became increasingly blue over time. After ten minutes the color was much more pronounced.

Within two minutes of sitting down, the man’s legs returned to their natural color.

He was diagnosed with postural orthostatic tachycardia syndrome (POTS), a form of dysautonomia that causes an abnormal increase in heart rate on standing.

A diagnosis of POTS is not uncommon in COVID survivors. But since symptoms vary from person to person, there has been little awareness of this.

“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.” 

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Awareness can make blue legs syndrome less alarming

Dr. Sivan points out that POTS is also seen following other conditions like fibromyalgia and chronic fatigue syndrome.

“We need more awareness about dysautonomia in long-term conditions; more effective assessment and management approaches, and further research into the syndrome,” he says.

The takeaway: if you have recovered from COVID-19, or if you are a “long-hauler” and start to have this “blue leg” syndrome, don’t panic.

See your doctor right away. Perhaps you’ll want to take this post with you. Many doctors are still not aware of this symptom of long COVID. It could help you get a proper diagnosis and treatment for your condition.

You may also want to talk to them about transcutaneous vagus nerve stimulation. In previous research with COVID long-haulers, the therapy appeared to rebalance the autonomic nervous system and resulted in an improvement of symptoms.

Sources:

Raising awareness of Long Covid ‘blue legs’ symptom — Science Daily

Raising awareness of Long Covid blue legs symptom — University of Leeds

Acrocyanosis — Merck Manual