Long COVID and Lyme Disease: Overlapping Symptoms and Diagnostic Challenges

Long COVID and Lyme disease can share similar symptoms
Fatigue, pain, and brain fog may overlap
Accurate diagnosis remains important

Long COVID and Lyme disease can share symptoms including fatigue, pain, brain fog, dizziness, and exercise intolerance. Researchers have examined whether individuals with a history of Lyme disease may be at risk for developing Long COVID after COVID-19 infection.

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 survey reported that nearly one in five individuals with a history of Lyme disease who contracted COVID-19 developed Long COVID. Individuals with Long COVID share many of the same symptoms reported by patients with Lyme disease.¹

How Long COVID and Lyme Disease Symptoms Overlap

Long COVID and Lyme disease may present with similar symptoms, including fatigue, cognitive difficulties, pain, dizziness, sleep disturbances, and exercise intolerance. These overlapping symptoms can make diagnosis challenging, particularly in individuals with a prior history of tick-borne illness.

Common Long COVID symptoms include fatigue, brain fog, dizziness, sleep disturbances, and exercise intolerance—symptoms that may also be reported by some Lyme disease patients.

Careful clinical evaluation is important to determine whether symptoms are related to Long COVID, Lyme disease, another medical condition, or a combination of factors.

COVID-19 Vaccination and Long COVID

Some individuals with a history of Lyme disease have been reluctant to take the COVID-19 vaccine.²

Evidence suggesting that vaccination may reduce the risk of Long COVID was summarized in an NPR report.³ At the time of publication, much of the evidence came from preprint studies and required further confirmation.^4-6

Frequently Asked Questions

Can Lyme disease symptoms resemble Long COVID?

Yes. Fatigue, brain fog, pain, dizziness, sleep disturbances, and exercise intolerance may occur in both conditions.

Can someone have both Long COVID and Lyme disease?

Yes. An individual with a history of Lyme disease can later develop COVID-19 and experience persistent symptoms following the viral infection.

How do doctors distinguish Lyme disease from Long COVID?

Doctors consider symptom history, timing of illness, physical findings, laboratory testing, and other possible medical explanations when evaluating persistent symptoms.

Clinical Takeaway

The risk of developing Long COVID after COVID-19 infection should be considered alongside concerns about Lyme disease.

Because Long COVID and Lyme disease may share symptoms such as fatigue, pain, brain fog, dizziness, and exercise intolerance, careful clinical evaluation is important.

We need more research to ensure that patients with persistent Lyme disease symptoms are not automatically dismissed as having Long COVID alone.

Sources

1. COVID-19 and Lyme disease symptoms overlap. COVID-19 and Lyme disease symptoms overlap. Last accessed April 4, 2022.
2. Are you reluctant to take the COVID-19 vaccine? Are you reluctant to take the COVID-19 vaccine? Last accessed April 4, 2022.
3. Stone W. Evidence grows that vaccines lower the risk of getting Long COVID. NPR. Last accessed March 27, 2022.
4. Association between vaccination status and reported incidence of post-acute COVID-19 symptoms in Israel. Last accessed April 4, 2022.
5. Ayoubkhani D, et al. Risk of Long COVID in people infected with SARS-CoV-2 after two doses of a COVID-19 vaccine. Last accessed April 4, 2022.
6. Simon MA, et al. Reduced Incidence of Long-COVID Symptoms Related to Administration of COVID-19 Vaccines. Last accessed April 4, 2022.

Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.

Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention