He wasn’t losing his mind—he was losing time. Each week blurred into the next as fatigue and fog deepened. When he finally came to my office, he’d already accepted a diagnosis that wasn’t quite right.
A patient came to me months after recovering from COVID-19. He still felt drained—exhausted, foggy, and plagued by a burning sensation in his head. He told me, “I’ve accepted that I’m one of those long COVID cases.”
But as I listened and examined his history more closely, several details didn’t fit. The question of long COVID or Lyme disease became increasingly relevant—the fatigue had actually started before his COVID infection. He also described joint pain, tingling in his hands, and night sweats—symptoms far more suggestive of a tick-borne illness than a viral aftermath.
Recognizing Lingering Lyme Disease Symptoms vs. Long COVID
Post-infectious syndromes like long COVID and post-treatment Lyme disease syndrome (PTLDS) can look nearly identical:
- Brain fog and slowed processing
- Persistent fatigue
- Head pressure or burning
- Muscle and joint pain
- Dysautonomia or temperature sensitivity
But similarity doesn’t mean sameness. His pattern of symptoms—especially the night sweats, migratory pain, and sensitivity to light—made me reconsider whether this was truly post-COVID at all.
Further testing revealed evidence of Lyme disease and Babesia co-infection—infections that likely predated COVID and re-emerged during immune disruption.
The Turning Point
We began a course of targeted antibiotics and anti-malarial therapy. Within weeks, the lingering Lyme disease symptoms began to lift—the head pressure eased, fatigue lessened, and concentration returned. For the first time in months, he felt like himself returning—not the exhausted shadow he’d been living as.
He didn’t have a post-viral syndrome after all. He had an untreated tick-borne infection hiding beneath the surface, unmasked by another illness.
Why It Matters
Since 2020, millions have been told that persistent symptoms after COVID are “long COVID.” For many, that’s true. But for some, the label has delayed the right diagnosis—especially in regions where tick exposure is common.
Tick-borne infections can imitate or even amplify post-viral inflammation. Without a full evaluation, a patient recovering from one infection may be living with another.
If you’ve been diagnosed with long COVID but symptoms started before infection, worsened unexpectedly, or include features like night sweats and migratory joint pain, ask your clinician about tick-borne illness testing.
Clinical Takeaway
Lingering symptoms deserve investigation, not assumption. When “long COVID” doesn’t behave like COVID—when symptoms predate infection, include atypical features, or fail to improve—clinicians should revisit the differential diagnosis, including Lyme disease and co-infections. A careful history and appropriate testing can reveal what viral illness may have obscured.
Every lingering case deserves a second look. Not all long hauls begin with COVID—sometimes, they begin in the woods.
Have you experienced lingering Lyme disease symptoms that were initially diagnosed as long COVID—or discovered your “long COVID” was something else entirely? Share your story below. Your experience could help someone finally find the right diagnosis and begin true healing.
Additional Resources
- Pubmed – Clinical Overview of Long COVID
- Lyme science blog – Lyme disease misdiagnosed as Long COVID
- Lyme science blog – Long covid Q&A sponsored by Project Lyme
