Long Covid patient's legs turn blue after 10 minutes of standing, new scientific research claims

Long Covid, also referred to as post-acute sequelae of SARS-CoV-2 infection (PASC), continues to perplex scientists and healthcare professionals alike, with unpredictable and varied symptoms. A scientific study published in The Lancet Journal has unveiled yet another baffling symptom – patients' legs turning blue after standing for mere 10 minutes. This study adds to the burgeoning list of symptoms - both physical and neurological, associated with the prolonged impact of Covid-19.

According to the research, some Long Covid patients experienced significant changes in the colour of their legs from normal to blue within 10 minutes of standing. The symptoms were reported by the patients while participating in a study investigating the long-term effects of Covid-19.

This phenomenon, medically referred to as "dependent rubor," is associated with impaired blood circulation. When patients stand, gravity pulls blood down into their legs. The body's circulatory system struggles to pump it back up, resulting in blood pooling in the lower extremities.

This makes the legs appear blue or purple, signalling a lack of oxygen. The patients also reported accompanying symptoms of fatigue, dizziness, and fainting, which could be linked to postural orthostatic tachycardia syndrome (POTS) - a condition that affects blood flow and increases the heart rate upon standing.

The study described the case of a 33-year-old man who developed a condition called acrocyanosis, which refers to blood pooling in the veins of the legs. A minute after standing, his legs began to redden and became increasingly blue over time, with the veins becoming more prominent, the study from the University of Leeds, UK, said.

"This was a striking case of acrocyanosis in a patient who had not experienced it before his Covid-19 infection," said Manoj Sivan, the study's author and associate clinical professor at the university's School of Medicine.

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 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, both of which affect muscles and cause pain.

The researchers said that the patient's case highlighted the need for greater awareness of this symptom among people experiencing this condition. "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," said Sivan.

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