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Long COVID and Lyme Disease Connection | Dr. Daniel Cameron


The Connection Is Real—and I’ve Studied It
If you’re experiencing persistent symptoms after COVID-19 and have a history of Lyme disease, you’re not imagining things. The overlap between Long COVID and chronic Lyme disease isn’t coincidental—it’s documented.
As a physician who has treated Lyme disease patients for 37 years, an epidemiologist, and a researcher who has published peer-reviewed studies on this exact question, I see the same patterns in both conditions: persistent symptoms that won’t resolve, doctors who dismiss your experience, and a medical system that isn’t equipped to help you.

What My Research Found

In 2023, I published a peer-reviewed study in the journal Antibiotics examining what happens when individuals with a history of Lyme disease contract COVID-19 or receive the COVID-19 vaccine. The study included 889 participants.

The key findings:

One in five Lyme patients who contracted COVID-19 reported Long COVID. This is a striking number that suggests a history of Lyme disease may be a risk factor for developing Long COVID—a connection the medical community has largely ignored.
Neurological symptoms drove the difference. Patients with both Lyme history and Long COVID experienced significantly worse neurological symptoms compared to those who had COVID without developing Long COVID. These symptoms included numbness and tingling, balance problems, irregular heartbeat, shooting pains, and sensitivity to light and sound.
The symptom burden is severe. Using the General Symptom Questionnaire-30 (GSQ-30), a validated measure I use in my research, we found that individuals with a history of Lyme disease experience symptom burdens worse than patients with traumatic brain injury, depression, or early Lyme disease.
Average illness duration: 14.5 years. Participants in our study had been ill far longer than patients in NIH-sponsored trials, reflecting what I see in clinical practice—these patients remain sick for years, often decades.
Read the full study in Antibiotics (2023) →

Research findings from the COVID-19 and Lyme Disease Survey

  1. Individuals with Lyme disease who contract COVID-19
  2. A 16-year-old girl and 28-year-old woman with Lyme disease and COVID-19
  3. Severity of Lyme disease even without contracting COVID-19
  4. Severity of Lyme disease: Five patient cases
  5. Lyme disease patients at greater risk for severe COVID-19
  6. Podcast: Lyme disease and Long COVID in a 16-year-old girl
  7. COVID-Lyme disease survey: First findings with Dr. Horowitz

Why Long COVID and Lyme Disease Overlap

Both conditions share fundamental characteristics that explain why patients experience such similar journeys.

The Same Symptom Domains

My research uses the GSQ-30 to measure symptoms across four domains. Both Long COVID and chronic Lyme disease affect all four:

  1. Pain and fatigue: Crushing exhaustion that doesn’t improve with rest, widespread pain that migrates throughout the body
  2. Neuropsychiatric symptoms: Brain fog, memory problems, difficulty concentrating, anxiety, depression
  3. Neurological symptoms: Numbness, tingling, balance problems, heart palpitations, temperature dysregulation
  4. Viral-like symptoms: Low-grade fevers, swollen lymph nodes, general malaise

Dysautonomia: The Common Thread

Both conditions frequently trigger autonomic nervous system dysfunction. POTS (Postural Orthostatic Tachycardia Syndrome) appears in Lyme patients and Long COVID patients alike. Patients describe the same experiences: standing up and feeling their heart race, dizziness, temperature swings, digestive problems.
Learn more about Autonomic Dysfunction and Lyme Disease →

Post-Infectious Syndrome as a Framework

Long COVID and Post-Treatment Lyme Disease Syndrome (PTLDS) are both post-infectious syndromes—conditions where symptoms persist long after the initial infection should have resolved. The mechanisms may include ongoing immune activation, autoimmune responses, microvascular damage, or persistent infection.
The medical establishment has been slow to acknowledge PTLDS for decades. Now, with millions experiencing Long COVID, there’s renewed interest in understanding why some infections lead to chronic illness. Lyme patients have been living this reality—and being dismissed for it—for years.
Understanding how Lyme disease becomes chronic—and how to prevent it—offers lessons that apply to Long COVID as well. See Preventing Long-Term Lyme Disease.

Symptom overlap, shared mechanisms, and clinical comparison

  1. Lyme, Long COVID, or Both? Making Sense of Persistent Symptoms
  2. Lyme vs Long COVID: The Overlap Doctors Need to See
  3. COVID-19 and Lyme disease symptoms overlap
  4. POTS similarities seen in Long COVID and Lyme disease
  5. COVID-19 or Lyme disease triggers autoimmune reaction
  6. COVID-19 chronic manifestations: Lessons from Lyme disease
  7. Similarities of Long COVID and Lyme disease in children

The Shared Patient Experience

Beyond the clinical overlap, Long COVID and Lyme patients share something else: the experience of not being believed.

The Same Dismissal

Long COVID patients are hearing what Lyme patients have heard for decades:

  1. “Your tests are normal, so nothing is wrong.”
  2. “It’s probably just anxiety.”
  3. “You need to exercise more.”
  4. “Have you considered that this might be psychological?”

This isn’t medicine. It’s medical abandonment.
This pattern reflects broader ethical failures in Lyme disease care—failures now being repeated on a massive scale with Long COVID.

The Same Diagnostic Delays

Both conditions lack definitive tests that satisfy skeptical physicians. Both involve symptoms that fluctuate, making it easy for doctors to attribute them to stress or mood. Both leave patients questioning their own experience after being told repeatedly that nothing is wrong.

The Same Fight for Treatment

Patients with both conditions often must advocate fiercely for themselves, educate their own doctors, and seek out specialists willing to listen. Many travel hours to find a physician who takes them seriously.
Learn more about Medical Misconceptions That Harm Lyme Patients →

Misdiagnosis, diagnostic delays, and the shared patient journey

  1. Lyme disease misdiagnosed as Long COVID
  2. Is it Long COVID or Lyme disease?
  3. Long COVID or Lyme Disease? When Symptoms Don’t Add Up
  4. No Lyme disease evaluation as part of a post-COVID-19 assessment
  5. COVID-19 long haulers and Lyme alike
  6. Case study: Lyme disease in patient with Long COVID

What This Means for Patients

If You Have Lyme History and Contracted COVID-19

Based on my research and clinical experience, here’s what you should know:
Your symptoms may be harder to differentiate. Fatigue, brain fog, and pain after COVID may be Long COVID, a Lyme flare, or both. A physician familiar with both conditions can help sort this out.
Your Lyme history matters—tell your doctors. Many physicians don’t think to ask about tick-borne illness history when evaluating Long COVID. Bring it up yourself. It may be relevant to your care.
Monitor neurological symptoms closely. Our research found that neurological symptoms specifically were worse in Lyme patients with Long COVID. Report new or worsening numbness, tingling, balance problems, or heart palpitations.
Advocate for comprehensive evaluation. You deserve a physician who considers your complete history, not one who dismisses your concerns because your basic labs are normal.

If You Have Long COVID and Suspect Lyme

Some Long COVID patients later discover they have undiagnosed Lyme disease or a co-infection like Babesia or Bartonella. If you have:

  1. A history of tick exposure or unexplained tick bites
  2. Symptoms that predate your COVID infection
  3. Migratory joint pain, specific rashes, or other Lyme-associated symptoms
  4. Symptoms that don’t fit the typical Long COVID pattern

…it may be worth discussing Lyme disease testing with a knowledgeable physician.

COVID-19 Risk and Vaccine Concerns for Lyme Patients

The COVID-19 and Lyme disease survey also examined how Lyme disease patients responded to the pandemic and the COVID-19 vaccine. More than 1,100 individuals with a history of Lyme disease shared their experiences, including their vaccine decisions, side effects, and concerns. These findings help patients with tick-borne illness make informed decisions about their health.

Risk, vaccine decisions, and survey findings

  1. Risks for Lyme disease patients in a COVID-19 pandemic
  2. COVID-19 vaccine side effects in Lyme disease patients
  3. 28-year-old woman: Side effects of COVID-19 vaccine
  4. Can Lyme disease patients get the COVID-19 vaccine?
  5. Low COVID-19 vaccine trust for Lyme disease
  6. Concerns with the COVID-19 vaccine for Lyme patients

The Bigger Picture: Post-Infectious Illness

COVID-19 has done something unexpected: it has forced the medical community to acknowledge that infections can cause persistent, debilitating illness that doesn’t show up on standard tests.
For Lyme patients, this is bittersweet. The same medical establishment that dismissed their suffering for years is now scrambling to understand Long COVID. The same symptoms. The same diagnostic challenges. The same patient experiences.
My hope is that research into Long COVID will illuminate mechanisms that apply to chronic Lyme disease as well—and that physicians will finally recognize that post-infectious syndromes are real, serious, and treatable.
In the meantime, I continue to see patients with both conditions in my practice. I believe them. I treat them. And I continue to research the connections that others overlook.
For patients navigating recovery from either condition, improvement is possible. See Lyme Disease Recovery and Long-Term Outlook.

Frequently Asked Questions

Can Lyme disease increase the risk of developing Long COVID?
Yes. In my peer-reviewed study of 889 participants, one in five Lyme patients who contracted COVID-19 developed Long COVID, suggesting a history of Lyme disease may be a risk factor.

What symptoms do Long COVID and Lyme disease share?
Both conditions involve fatigue, brain fog, pain, neurological symptoms like numbness and tingling, and autonomic dysfunction including POTS, temperature dysregulation, and exercise intolerance.

Can Long COVID be misdiagnosed as Lyme disease or vice versa?
Yes. The symptom overlap is significant enough that some patients with Lyme disease are misdiagnosed with Long COVID, and some Long COVID patients may have undiagnosed tick-borne infections contributing to their symptoms.

Should Long COVID patients be tested for Lyme disease?
If a patient has a history of tick exposure, symptoms that predate their COVID infection, or symptoms that do not fit typical Long COVID patterns, Lyme disease testing should be considered.

What is dysautonomia, and why does it matter in both conditions?
Dysautonomia is dysfunction of the autonomic nervous system that can cause dizziness, rapid heart rate, temperature swings, and digestive problems. It is a common feature of both Long COVID and chronic Lyme disease.

Related Resources

  1. Understanding Lyme Disease Symptoms
  2. Understanding Lyme Disease Test Accuracy
  3. Understanding Lyme Disease Coinfections
  4. Babesia: What Lyme Patients Need to Know
  5. Post-Treatment Lyme Disease Syndrome (PTLDS)
  6. Preventing Long-Term Lyme Disease
  7. Lyme Disease Recovery and Long-Term Outlook
  8. Ethics, Uncertainty, and Medical Abandonment in Lyme Disease
  9. Lyme Disease Misconceptions
  10. Pediatric Lyme Disease

About the Author

Daniel J. Cameron, MD, MPH, is a nationally recognized Lyme disease expert with 37 years of clinical experience. He served as President of ILADS (International Lyme and Associated Diseases Society) and was first author of the ILADS treatment guidelines. As an epidemiologist, he has published peer-reviewed research on Lyme disease and Long COVID. He continues to treat patients and advocate for better care.
Contact Dr. Cameron’s Office →

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