Nearly One in Five Individuals with COVID-19 and Lyme Disease History Developed Long COVID

In my peer-reviewed study published in the journal Antibiotics (2023), I examined the experiences of 889 individuals with a history of Lyme disease who contracted COVID-19. The findings were striking: nearly one in five developed Long COVID.This rate is significantly higher than the general population, where approximately one in ten individuals develop Long COVID after infection.

Key Findings

Participants with a history of Lyme disease were recruited through a snowball sampling strategy via social media. Of 1,168 individuals who completed the survey, 288 contracted COVID-19.The symptom burden, measured by the GSQ-30 questionnaire, was significantly higher for individuals with both Lyme disease and COVID-19 compared to those with Lyme disease alone (48.2 vs. 43.1, p = 0.008).The most common symptoms reported were:

1. Feeling fatigued or having low energy
2. Feeling worse after normal physical activity
3. Not feeling rested on awakening
4. Muscle aches or pains
5. Trouble falling or staying asleep
6. Feeling panicky, anxious, or worried
7. Trouble finding or retrieving words
8. Joint pain or swelling

Neurological symptoms drove the difference between those who developed Long COVID and those who did not.

Why This Matters

The symptom overlap between Long COVID and Lyme disease creates a diagnostic challenge. Patients may be told they have Long COVID when an underlying or concurrent tick-borne infection has been missed. Conversely, Lyme patients who contract COVID-19 may face compounding illness that worsens their overall symptom burden.Both conditions can cause fatigue, brain fog, autonomic dysfunction, pain, and sleep disturbance. Without careful evaluation, one may mask the other.

Clinical Implications

These findings suggest that individuals with a history of Lyme disease may be at increased risk for developing Long COVID. Clinicians should:

1. Screen Long COVID patients for possible tick-borne illness, especially in endemic areas
2. Recognize that Lyme patients who contract COVID-19 may experience worsening symptoms
3. Avoid dismissing persistent symptoms as “just Long COVID” without ruling out other causes

Editor’s note: We need more research to ensure individuals with persistent tick-borne infections are not dismissed as having Long COVID alone. Both conditions deserve thorough evaluation and individualized care.

For a comprehensive overview of the Long COVID and Lyme disease connection, see Long COVID and Lyme Disease: What Patients Need to Know.