Lymphedema and COVID-19By: Lindsay Davey, MScPT, MSc, CDT
March 29, 2020
Editors: Ryan Davey, PhD and Lindsay Davey, MScPT, MSc, CDT
Lymphedema and COVID-19 – Risk
Lymphedema is not expected to increase your risk for COVID-19 infection – having lymphedema should neither increase your susceptibility to COVID-19 infection, nor increase the severity of COVID-19 symptoms.
Generally speaking, COVID-19 complications tend to arise in people whose lung function is impaired, or in people who have a compromised immune system, and neither of which are commonly associated with primary or secondary lymphedema per se. While normal immune function can become impaired in lymphedematous limbs, this is a local immune dysfunction rather than a systemic one (whole body). Localized immune suppression increases the risk of local skin infection (cellulitis) but does not increase the risk of COVID-19 infection which targets the upper respiratory tract. Lymphedema is also not typically associated with an impairment in lung function, although in very rare cases of primary (hereditary) lymphedema, lung issues are possible – if this were the case for you, you are most likely already aware of it.
You may be at increased risk of the severe form COVID-19 infection if you have other chronic conditions such as: cardiovascular disease, chronic respiratory disease, diabetes, or if you have a weakened immune system due to medications or treatment related to cancer (recent or on-going chemotherapy, for example).
Lymphedema COVID-19 – Management
For those who wear compression garments that cover the hand or wrist, keeping the garment free of contamination can be a challenge. To help, consider wearing a disposable glove over your compression glove when you are out and about. When you arrive at your destination wash both hands with your disposable glove still on to ensure that your non-gloved hand is clean, before removing and tossing out the disposable glove.
An important component of lymphedema management is exercise. Due to social distancing and self-isolation efforts your exercise routines may have changed. We recommend setting up a basic home exercise program to maintain cardiovascular fitness and lymphatic pumping.
Even though we are not currently available for in-clinic visits due to our COVID-19 related closure, we are available to help you with your self-management (self-massage techniques, home exercise programming,etc) by video call if you need support.
Thank you very much of your information.
I had breast cancer and I suffer from lymph-edema.
My Lymphocytes and Neutrophils are always at the minimum range. Am I at risk of the corona virus?
If you are on the low end of the normal range then you probably don’t have any special risk of severe infection. The risk would be greater for someone who is on immunosuppressant drugs or chemotherapy who fall well below the normal range. Best wishes! Ryan
I was worried lymphedema is an underlying condition until
I read this article. You are so helpful. Thank you very much.
I’m glad it was helpful Barbara! I hope you’re well. Lindsay :)
should I require a covid-19 shot in the rear instead of my affected arms due to mild lymphedema…and will they be allowed to give it in my rear…age 74…breast cancer survivor with mild lymphedema in both my arms
This is a valid question indeed. I’m happy to say, that with mild lymphedema, there should be no issue with you obtaining the COVID-19 vaccination in your arm. Similar to the flu shot, the local reaction to the arm should be minimal, and should not elicit any worsening of your arm swelling. The issue with injections (and I.V.’s, or blood draws, etc) is the break of the skin in the area local to where the needle is inserted, and thus, if sterile technique is used by the nurse providing the vaccine, there should not be any issue in receiving it in either arm. You could always apply polysporin or another anti-microbial ointment at the site of the injection to further lessen the risk of any infection at this small break in the skin, but again, if you have received the flu vaccine without issue in the past, there should be no difference here. You can always speak to your physician, or do mention it to whoever is administering the vaccine, to make sure they’re aware of your lymphedema and if an alternate site is an option, you may wish to do so at the time. Best wishes to you Mary! Lindsay Davey
Further to the vaccine. What should I do if there is a localized or regional inflammatory response? Cool compresses? Gentle massage around the site? (rather than on it?)
I would say that yes, a cool compress on the area in the upper arm if it’s inflamed, is a good idea. If you are doing lymphatic massage, I don’t see any reason why you couldn’t continue per your usual strokes, however, if it’s tender in the area which it very well may be, then yes, you could simply adjust to ‘go around’ the area of the vaccination, until things settle down. I hope that helps!
Best wishes, Lindsay Davey