COVID-19 and Cutaneous Disorders: What’s Being Reported? A Meta-Analysis from Observational Studies and Case Reports

Abstract

Background: Coronavirus disease (COVID-19) is related to several extrapulmonary disorders; however, little is known about the skin disorders characteristics and prevalence.
 Objetive: Summarize and evaluate the skin disorders’ characteristics and prevalence reported in the literature.
 Methods: We conducted a search on PubMed, SciELO and ScienceDirect between 01/01/2020 to 09/28/2020. The target population was patients with skin disorder and a positive diagnosis for COVID-19. All observational studies, research letters, case series and case reports were selected. We evaluated observational studies using Random- effects models to calculate the weighted mean prevalence and 95% confidence interval (CI). We evaluated the case studies using the chi-square test for dichotomous variables and the Mann-Whitney test for continuous variables.
 Results: Eighty-seven patients from case reports and six observational studies with 363 patients were selected. Eleven types of skin disorders in COVID-19 confirmed patients are described. Skin disorder weighted mean prevalence was 9.9% (95% CI: 3.7-24.1). Maculopapular rash was the most prevalent disorder (37.5%; 95% CI: 21-57%). Latency was significantly lower in patients over 60 years old (p=0.041).
 Conclusion: Each cutaneous manifestation has its particularities and may or may not accompany other signs and symptoms. It is possible for the elderly to have COVID-19- related skin disorders early.

“COVID toes”: A meta‐analysis of case and observational studies on clinical, histopathological, and laboratory findings

“…Of the described cutaneous manifestations, chilblain‐ and pernio‐like lesions are among the most controversial. 1 Perniosis (chilblains) is commonly defined as an acral skin lesion caused by poor blood circulation due to prolonged cold exposure. Vasculitis, Raynaud's phenomenon, acrocyanosis, and cryoglobulinemia are the main differential diagnoses.…”

“…Several extrapulmonary manifestations are associated with infection with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), the causative agent of coronavirus disease 2019 (COVID‐19). Of the described cutaneous manifestations, chilblain‐ and pernio‐like lesions are among the most controversial 1 . Perniosis (chilblains) is commonly defined as an acral skin lesion caused by poor blood circulation due to prolonged cold exposure.…”