Characteristics of herpes zoster infection in patients with COVID‐19: a systematic scoping review

Abstract

Background Although there is literature reporting correlations between varicella zoster virus (VZV) infections and COVID-19, insufficient evidence exists in this regard. This scoping review aims to identify the existing evidence regarding clinical characteristics of primary VZV infection or reactivation in COVID-19. Methods Following the PRISMA Extension for Scoping Reviews, MEDLINE and EMBASE were searched for all peer-reviewed articles with relevant keywords including "Zoster," "Herpes," and "COVID-19" from their inception to November 20, 2021.Results A total of 19 articles with three observational studies and 16 case reports or series were included. Primary VZV infections or reactivation were observed in 25 patients.Forty-eight percent of the patients had disseminated VZV infection. The median time of VZV-related rash after the onset of respiratory symptoms was 7.0 days (interquartile range: 0-18.8). Those with COVID-19 and primary VZV infection or reactivation had low lymphocyte counts with a median of 0.67 9 10 3 /ll. ConclusionThis scoping review identified uncertainty and a lack of strong evidence to see the association between primary VZV infection or reactivation and COVID-19. However, those with COVID-19 may be more likely to have disseminated VZV, which poses an additional challenge from an infection prevention standpoint. Future studies are warranted to determine the association between primary VZV infection or reactivation and long-term consequences related to COVID-19.the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews (PRISMA-ScR). 10,11 Appendix S1 is the PRISMA-ScR checklist of the present study.Search strategy MEDLINE and EMBASE searches were conducted for all peer-reviewed articles from inception to November 20, 2021.

Long‐term risk of herpes zoster following COVID‐19: A retrospective cohort study of 2 442 686 patients

“…Our findings are consistent with those of relevant studies 26,33 . Bhavsar et al employed the US MarketScan Commercial Claims and Encounters and Medicare Supplemental Database and Optum Clinformatics Data Mart to assess the risk of developing HZ following a COVID‐19 diagnosis in adults ≥50 years 33 .…”

“…[23][24][25] However, studies have only sporadically reported the development of HZ following COVID-19. [26][27][28] These findings suggest a close association between COVID-19 and HZ. However, a lack of strong evidence exists to support this hypothesis due to limited research.…”

“…Several studies have demonstrated sustained cellular immune dysregulation with a decrease in circulating CD4+ and CD8+ T lymphocytes in patients who have recovered from acute COVID‐19 23–25 . However, studies have only sporadically reported the development of HZ following COVID‐19 26–28 . These findings suggest a close association between COVID‐19 and HZ.…”

“…These findings suggest a close association between COVID‐19 and HZ. However, a lack of strong evidence exists to support this hypothesis due to limited research 26–28 . Therefore, this study compiled data from a large database to investigate the risk of HZ following COVID‐19.…”

“…However, a lack of strong evidence exists to support this hypothesis due to limited research. [26][27][28] Therefore, this study compiled data from a large database to investigate the risk of HZ following COVID-19. month of the index date, those who had received a zoster vaccine, and those with a history of zoster.…”