Long Covid symptom discovered as man's legs turn purple when he stands up

15 August 2023 , 11:01

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The man's legs a he stands, two minutes and 10 minutes later (Image: The Lancet/Manoj Sivan)

A rare and mysterious new Long Covid symptom has been identified by doctors after a man - who caught the virus twice in 18 months - was left with his legs rapidly changing colour when he stands up.

The 33 year old man's bizarre and disabling symptoms see his legs turn to a deep purple. As well as the legs rapidly changing colour the man reported that for the last six months, every time he stands up they would feel "progressively feel heavy, tingly, itchy, and become dusky in colour".

In just two minutes of standing the man's legs were noticeably red and by 10 minutes they appear a more deep purple. The man reported that he would also get a rash which spreads over his feet, but added that his legs would return to their normal colour and all the other symptoms would abate if he lay down.

Discussed in this week's edition of the medical journal The Lancet, the piece added that the man "had a mild SARS-CoV-2 infection, confirmed by PCR, 18 months before" he was first seen and had "a suspected further SARS-CoV-2 infection six months later. He had been diagnosed with post-COVID-19 condition (also known as long COVID) in a specialist clinic three months before we saw him reporting a 12-month history of disabling and delayed post-exertional exhaustion, disproportionate to the effort made; he also reported muscular pain, sleep disturbance, visual difficulties, sexual dysfunction, and brain fog. The patient had been diagnosed with postural orthostatic tachycardia syndrome two months before we saw him, by a cardiologist".

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“This was a striking case of acrocyanosis in a patient who had not experienced it before his Covid-19 infection”, co-author Dr Manoj Sivan, associate clinical professor and honorary consultant in rehabilitation medicine at the University of Leeds told Metro.

“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 [malfunctioning of the nervous system] in long COVID so that clinicians have the tools they need to manage patients appropriately.”

The report added how they intended to treat the man's symptoms. It read: "We diagnosed dysautonomia secondary to SARS-CoV-2 infection and associated with long COVID. We explained that the leg discolouration was due to venous pooling and cutaneous ischaemia; we recommended he increase his fluid intake, increase his salt intake, and do muscle strengthening exercises.

Kelly-Ann Mills