Cutaneous manifestations of hospitalized COVID‐19 patients in the VIRUS COVID‐19 registry

Abstract

Cutaneous manifestations of hospitalized COVID-19 patients in the VIRUS COVID-19 registry Dear Editor, In the United States alone, over 65 million cases of COVID-19 have been diagnosed till mid-January 2022, likely underestimating the prevalence as many individuals are asymptomatic and thus untested. 1 Given the global burden and death toll of this pandemic, understanding the presenting signs, disease course, predictors of severity and outcomes, and long-term consequences of COVID-19 is important.Current literature has documented a vast array of cutaneous manifestations of COVID-19 from maculopapular to vesicular morphology to chilblain-like lesions. 2 We aimed to assess the prevalence of skin findings, characterization of these presentations, clinical outcomes, and treatment regimens using a multinational database of COVID-19-positive hospitalized patients.We designed a retrospective observational descriptive study of dermatological symptoms from a large international VIRUS: COVID-19 registry conducted by the Society of Critical Care Medicine (SCCM) Discovery Network. VIRUS is a multinational database that collects and stores patient's data for those who are hospitalized with COVID-19. 3 The VIRUS Registry has enrolled hospitalized patients with laboratory confirmed COVID-19 patients. A laboratory confirmed case is defined as a positive result using a reverse-transcriptase-polymerase chain reaction (RT-PCR) assay.We created data elements based on smaller studies that were published for patients with dermatologic manifestations of COVID-19. We also utilized the expertise of a dermatologist (A.A.) to determine what data points would be valuable to add.The data elements for inclusion were selected to capture the types of skin manifestations that develop, patient demographics, dermatologic comorbidities, existing skin allergies, treatments, and their outcomes. These data elements were used to create an Excel document for collection. To collect dermatological symptoms for each patient, we sent an Excel survey to the sites that recorded patients with "rash" in the database. All sites that mentioned "rash" as a symptom were invited to fill out this Excel form. If sites had noted "urticaria," "hives," "itch," or "mottle" in the Research Electronic Data Capture (REDCap) system, they were also asked to fill out this Excel. The charts were reviewed