The strange and ‘striking’ symptom of Long Covid doctors want you to be aware of

Greater awareness is needed of a “striking” symptom of Long Covid — a blue-hued discoloration of the legs known as acrocyanosis.

This is the message of experts from the UK, who report a case of a 33-year-old man whose legs turn blue — thanks to venous pooling of the blood — after standing for just 10 minutes.

According to the team, the discoloration starts within a minute of him getting up, beginning with a reddening that shifts to blue while the veins become more pronounced.

This effect, which began after the man had COVID-19, is accompanied by a “heavy, itchy sensation”. His legs return to their normal color within a couple of minutes of lying down.

Doctors have diagnosed the man with “postural orthostatic tachycardia syndrome” (POTS), a condition that causes an abnormal increase in heart rate on standing.

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Long Covid, the researchers explained, appears to affect multiple systems across the body and, accordingly, comes with a wide array of symptoms — many of which can impact one’s ability to perform routine daily activities.

One part of the body it can affect is the autonomic nervous system, which is responsible for regulating both blood pressure and heart rate.

Acrocyanosis, the team noted, has previously been observed in children with a dysfunction of this system — what doctors term “dysautonomia” — a common symptom of post-viral syndromes that is seen in such long-term conditions as Fibromyalgia and Chronic Fatigue Syndrome.

According to Dr Manoj Sivan of the University of Leeds and his colleagues, both dysautonomia and POTS are also common in people living with Long Covid.

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Dr Sivan 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.”

Dr Sivan added: “We need more awareness about dysautonomia in long term conditions, more effective assessment and management approaches, and further research into the syndrome.”

He concluded: “This will enable both patients and clinicians to better manage these conditions.”

The full findings of the study were published in the journal The Lancet.

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