Recently Lancet a case study of a 33-year-old man suffering from long Covid reported a “rapid purple discoloration” on the patient’s legs after he stood for 10 minutes. The patient had been experiencing this strange symptom for six months and apart from the purple discoloration, her legs also felt heavy and itchy. The symptoms will subside and the discoloration will fade once he lies down.
This condition is known as acrocyanosis and occurs when there is an accumulation of venous blood in the legs. Although bluish or purplish discoloration of the hands is more common in patients with acrocyanosis, it can occur around the feet after spasm of the small blood vessels in the area.
In a press release, Manoj Sivan, a clinical professor at the University of Leeds said, “This is a striking case of acrocyanosis in a patient who had never had it before he was infected with COVID-19.”
“Patients experiencing this may not realize that this may be a symptom of long Covid and dysautonomia (damage to the autonomic nervous system which regulates blood pressure and heart rate) and may be alarmed by what they are seeing. Likewise, doctors may not know the link between acrocyanosis and Long Covid,” Sivan added. “We need to ensure that there is more awareness of dysautonomia in Long Covid so that doctors have the tools they need to treat patients appropriately.”
Some of the risk factors that may make people more susceptible to an uncommon condition like acrocyanosis are a low body mass index, neurological disorders, living in an area with a cold climate, and working in a profession that is more outdoors-oriented. The exact incidence and prevalence of acrocyanosis are still unknown.
Sivan and his colleagues also diagnosed the 33-year-old male patient with postural orthostatic tachycardia syndrome (POTS). This condition is characterized by an increase in heart rate shortly after a person sits or lies down. Other POTS symptoms can include fainting and dizziness. Doctors tend to recommend POTS patients to increase their salt intake to try to combat this symptom.
According to the National Institutes of Health, POTS is an uncommon condition and affects about 0.2% of the general population. In the United States, researchers estimate that between 500,000 and 1,000,000 people are diagnosed with POTS. In previous research, Sivan and colleagues reported that POTS and dysautonomia can often develop in people who have had Covid for a long time.
That Lancet Studies further highlight that although long Covid affects at least 10% of the general population, it is possible that conditions that are not uncommon occur in some patients with long Covid. Long Covid more often manifests in the form of severe fatigue (also known as myalgic encephalomyelitis), brain fog, sleep problems, difficulty concentrating, loss of smell and taste, and depression and anxiety.
Recent studies have found that these symptoms can persist for more than 12 months although usually they may subside after three to six months in the majority of long-suffering Covid-19 patients.
“We need more awareness about dysautonomia in long-term conditions; more effective assessment and management approaches, and further research into this syndrome. This will enable patients and doctors to better manage this condition,” added Sivan further.
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