Acrocyanosis ('blue legs') in Long COVID

Our Chief Investigator (Dr Manoj Sivan) authored an article recently published in The Lancet - 'Venous insufficiency and acrocyanosis in long COVID: dysautonomia'

The article details the case of a man with Long COVID who upon standing experiences a rapid purple/blue discolouration of his legs (acrocyanosis), which progressively feel heavy, tingly, itchy, and become dusky in colour. A petechial rash (small red or purple spots) also appears occasionally over his feet.

The article has gained great traction across news outlets internationally, with 326 articles published on the story within 4 days of it being published and at the time of writing the article is in the top 5% of all research outputs scored by Altmetric (a system that tracks the attention that research outputs receive online).

Some news articles refer to this as an "unusual case", however the Lancet article has been widely shared and discussed on social media, and people across the globe have begun sharing their similar experiences. Showing the case is not that unusual and achieving the article's purpose of raising awareness of this visual phenomenon.

To further increase awareness, Dr Sivan is building a case series of people experiencing acrocyanosis. If people want to be included in this case series they can complete a proforma, providing details of their acrocyanosis history, other dysautonomia/POTS symptoms, known medical diagnoses, and treatments and investigations they have received. Also, if they have access to a blood pressure monitor, people can complete a NASA Lean Test (instructions on the proforma) and submit their recordings.

In addition to the above, Manoj is asking people experiencing acrocyanosis to photograph their affected extremities (arms and/or legs) before and after standing to evidence the change in colouration (details provided in proforma), and to record the time between the stimuli occurring and when the 'after' picture is being taken.

Click here to access the Acrocyanosis Proforma

 

In the case of the person in the Lancet article, standing is the stimulus for their acrocyanosis but for others it can be caused by other stimuli such as eating. Photographs and accounts from people experiencing acrocyanosis from other stimuli are also welcome.