We can better understand COVID-19 chronic manifestations if we understand the lessons from Lyme disease. Lyme disease was first described as an early disease in 1977 when an epidemic of oligoarticular arthritis occurred in three Connecticut communities, which involved 39 children and 12 adults. [1]
During this time, the Centers for Disease Control and Prevention (CDC) focused their attention on the acute manifestations of Lyme disease, specifically an erythema migrans rash, 7th nerve palsy, heart block, Lyme arthritis, and meningitis.
However, cases of chronic illness due to Lyme disease were published by Logigian and colleagues.[2] The authors described patients ill for up to 14 years with fatigue, brain fog, and other neurologic symptoms.
The Parallel Between COVID-19 Chronic Manifestations and Lyme Disease
History is repeating itself. Just as chronic Lyme patients were dismissed for decades, patients with COVID-19 chronic manifestations — now called long COVID — are facing the same skepticism.
Both conditions share striking similarities:
- Persistent fatigue that doesn’t improve with rest
- Brain fog and cognitive difficulties
- Autonomic dysfunction affecting heart rate, blood pressure, and digestion
- Joint and muscle pain
- Symptoms dismissed as psychological
What Lyme Disease Teaches Us About COVID-19 Chronic Manifestations
The Lyme community has spent decades fighting for recognition. Patients were told their symptoms weren’t real. Research was underfunded. Treatment guidelines were rigid and failed to account for individual patient needs.
Now, millions of long COVID patients face the same battle. The lessons from chronic Lyme disease — the importance of listening to patients, individualized treatment, and acknowledging persistent symptoms — are more relevant than ever.
For patients navigating both conditions, see Perspective: Risks for Lyme disease patients during a COVID-19 pandemic.
Frequently Asked Questions
What are COVID-19 chronic manifestations?
COVID-19 chronic manifestations — often called long COVID — include persistent fatigue, brain fog, joint pain, and autonomic dysfunction that continue weeks or months after the initial infection.
How are COVID-19 chronic manifestations similar to chronic Lyme disease?
Both conditions involve lingering symptoms after infection, skepticism from mainstream medicine, and patients who are often told their symptoms are psychological. The pattern of medical dismissal is strikingly similar.
Why do some COVID-19 patients develop chronic symptoms?
The exact mechanism is still being studied, but possibilities include persistent viral fragments, immune dysregulation, and autonomic nervous system dysfunction — similar theories proposed for chronic Lyme disease.
Can lessons from Lyme disease help long COVID patients?
Yes. Decades of experience treating chronic Lyme patients — including individualized care, symptom management, and validating patient experiences — offer a roadmap for addressing COVID-19 chronic manifestations. For more on recovery, see Recovery and PTLDS.
Related Articles
Perspective: Risks for Lyme disease patients during a COVID-19 pandemic
References
- Arthritis Rheum. Steere AC, Malawista SE, Snydman DR, et al. Lyme arthritis: an epidemic of oligoarticular arthritis in children and adults in three Connecticut communities.. 977;20(1):7-17.
- N Engl J Med. Logigian EL, Kaplan RF, Steere AC. Chronic neurologic manifestations of Lyme disease. 1990;323(21):1438-1444.
