It started with an uncomfortable tingling and itchiness in his legs after standing for 10 minutes. Then, the he watched as his lower limbs turned blue right before his eyes. He was experiencing acrocyanosis, a pooling of blood in the extremities that had never afflicted him before. Doctors attributed the 33-year-old man’s symptoms, which started 18 months prior, to a bout of COVID-19 he had suffered then, according to a recent case study in The Lancet. His case provides new evidence that the virus may cause lasting dysautonomia—dysfunction of the autonomic nervous system—that experts are only beginning to understand.