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Covid blue legs is the discoloration of legs or developing a bluish rash in feet on standing is one of the long Covid manifestations that people may suffer from. In a report in Lancet journal, it was mentioned how a 33-year-old man with long Covid presented with rapid discoloration of legs on standing. His legs felt heavy and numb, and he felt an itchy sensation with bluish rash in feet. Experts say this could be due to the autonomic nerves getting impacted due to which the blood supply to the lower limbs may get affected and the return of blood back to the heart is impaired. The condition is known as acrocyanosis, or venous pooling and cutaneous ischemia. (Also read: Will ‘Eris’ Covid strain bring back face mask restriction in UK? Experts say)
“Long Covid, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), can lead to a range of persistent symptoms that affect various systems in the body, including cardiovascular and circulatory systems,” says Dr. Avi Kumar, Senior Consultant, Pulmonology, Fortis Escorts, Okhla Road, New Delhi.
“These symptoms have been seen in post Covid complications over a period of time. This is known as acrocyanosis caused by persistent discoloration of lower extremities resembling bluish or purple hue. It develops when the acute phase of infection has subsided. Cause is Covid impact on blood vessels and body inflammatory response because Covid can cause some damage to the blood vessels,” says Dr Kuldeep Kumar Grover, head of critical care & pulmonology, CK Birla Hospital, Gurugram.
“After Covid, once the acute infection goes away, there is a low-grade chronic inflammation which sets in and persistent chronic inflammation impacts various organs of the body and one of the systems is the autonomic nervous system,” says Dr Ashutosh Shukla, Medical Advisor and Senior Director – Internal Medicine, Max Hospital, Gurugram.
“So autonomic nerves are those nerves which are not under our voluntary control and these nerves control the tone of the blood vessels supplying the legs. some patients with long Covid or post Covid syndrome, develop blue legs and this happens because of the autonomic nerves getting impacted resulting in bluish discoloration of the legs because the blood supply to the lower limbs gets affected and the return of blood back to the heart is impaired. So, this is a typical syndrome, known as Blue leg syndrome which happens after Covid because of the low-grade chronic inflammation,” says Dr Shukla.
Dr Avi Kumar shares some potential causes for blue discoloration of the legs:
Poor circulation: Covid-19 can impact blood vessels and cause inflammation, which may affect blood flow to the extremities, resulting in blue discoloration.
Blood clot formation: Covid-19 has been associated with an increased risk of blood clot formation, which could potentially block blood flow to certain areas, leading to tissue discoloration.
Vascular issues: In some cases, the virus can damage blood vessels, causing them to become more constricted or less functional, affecting blood flow.
Autonomic nervous system dysfunction: Covid-19 can also affect the autonomic nervous system, which controls involuntary bodily functions such as blood vessel constriction. Dysfunction in this system might contribute to circulation issues.
Reduced oxygen supply: If there’s a problem with oxygen exchange in the lungs due to Covid-19-related lung damage, it could lead to reduced oxygen supply in the blood and cause discoloration in the extremities.
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.
“Please note that this is not an exhaustive list of potential causes, and each individual case can be unique. If you or someone you know is experiencing such symptoms, it’s crucial to seek medical attention promptly,” concludes Dr Kumar.
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