Cutaneous Vesicular of COVID-19 in Two Burn Patients

Abstract

Despite the whole world’s effort for controlling an ongoing global outbreak caused by new corona virus; it is still a major public health issue. Any hospitalized patient or outpatient in burn departments should be considered as a potential infectious source of COVID-19, which may cause an overwhelming of disease. However, there are no previous experiences about COVID-19 in burn patients all over the world, and here we reported two burn cases at Amir-al-Momenin Burn Hospital Affiliated to Shiraz University of Medical Sciences, Shiraz, Iran with skin manifestations, which were detected as a rarely COVID-19 symptom. A 13-year-old girl [total body surface area (TBSA): 18%] and a 37-year-old woman (TBSA: 30%) who had burn injuries by gas explosion and car accident, respectively were enrolled. After admission, some vesicular injuries were visible in burn area. To confirm, skin biopsy specimens were either sent for histopathology examination or for real time polymerase chain reaction (PCR) as follow: Herpes Simplex Virus (HSV), chicken pox, and potassium hydroxide (KOH) for fungal infections. All test results were negative. Although they had no symptoms of COVID-19, two swabs from nasopharyngeal and oropharyngeal samplings were taken, the result was negative either. Specimens were obtained from vesicular lesions for qRT-PCR assay of COVID-19. According to the molecular results for vesicular samples, all the results were positive for COVID-19. Unlike all other COVID-19 patients who have respiratory symptoms, SARS-COV-2 appeared by cutaneous vesicular and blisters in two burn cases.

Designing a Multicenter Registry of COVID-19 and Other Respiratory Infections in Fars, Iran

“…Moreover, in a specific insight, we can harmonize data about the treatment, outcomes, and well-being of patients who receive care over time. Several research papers have been derived from this registry, which were very useful for managing the disease and codification of guidelines [15][16][17][18]…”

“…Several research papers have been derived from this registry, which were very useful for managing the disease and codification of guidelines. 5,[15][16][17]…”

“…Based on standards for disease registries, the development of the registry program was done in several steps: (1) definition of the target population, (2) diagnosis of infected cases, (3) data gathering and appropriate related checklists, (4) data storage program, (5) assessing the quality of data, and, finally, (6) data analysis and reporting outputs. The current registry is designed in compliance with the standard Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, along with the declaration of Helsinki principles.…”

“…Although COVID-19 is known as a respiratory disease, some atypical manifestations have been seen, different from other types of viral respiratory infections [3,4]. Skin vesicular, cerebrovascular, neurological complications, dry eye, itching, and ocular involvement have been reported [5][6][7].…”

“…3,4 Skin vesicular, cerebrovascular, neurological complications, dry eye, itching, and ocular involvement have been reported. [5][6][7] On the other hand, co-infections with COVID-19 and other respiratory viruses (eg, influenza viruses, adenoviruses) have been detected. 8 Exact information about positive cases with respiratory diseases, especially SARS-CoV-2, their symptoms, complications, and comorbidities are required to clarify the ambiguities of these viral infections.…”