Doctors have described the case of a man whose legs turned purple, which they long believed was a rare complication from COVID. The 33-year-old man was referred to a specialist clinic after experiencing the unusual symptom for six months. After standing up, his legs began to feel heavy, itchy, and numb, while also seeing the unusual purple color appearing on his feet and legs. Symptoms appeared only when the patient stood up and disappeared when lying down.
The patient’s blood pressure and heart rate were measured by the team after lying down and standing for 8 minutes. His heart rate was found to be within the normal range while lying down, but was high at 127 per minute while standing. The man reported other symptoms, such as feeling distracted and weak, consistent with his postural orthostatic tachycardia syndrome (POTS).
Normally, when you stand up, some of your blood moves down your body due to gravity. Your body compensates for this by slightly increasing your heart rate and constricting your blood vessels to keep oxygen flowing to your heart and brain.
The patient’s feet turned purple after standing for a while.“If you are experiencing POTS, these automatic changes will not happen,” the British Heart Foundation website explains. “When you get into an upright position, blood flow to your heart and brain drops, and your heart rate rises to compensate and try to increase blood flow,” the statement continues.
The patient had a confirmed COVID-19 infection 18 months before he was seen by the team and a suspected infection six months later. He was seen and diagnosed by another specialist clinic following infections, due to fatigue, muscle pain, brain fog, and other symptoms associated with prolonged COVID-19. “There is growing evidence of a link between prolonged COVID and POTS dysautonomia,” the team writes in the paper, which can occur following viral infections. An earlier study found POTS occurring in 20 previously healthy patients following a COVID-19 infection.
Co-author of the article, Dr. “This was a striking case in a patient who had not experienced acrocyanosis prior to COVID-19 infection,” Manoj Sivan said in a statement. Similarly, clinicians may not be aware of the link between acrocyanosis and long-term COVID. We must ensure greater awareness of dysautonomia in the long COVID so that clinicians have the tools they need to manage patients appropriately.”
The study was published in The Lancet.
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