Herpes Zoster Co-Infection with COVID-19

Abstract

Clinical presentation of COVID-19 infection can be variable in the current pandemic even in patients presenting to the clinic with a mild history of upper respiratory complaints. Various cutaneous manifestations have been noticed in COVID-19 patients with herpes zoster (HZ) being one among them. HZ is an infection that results when varicella zoster virus reactivates from its latent state in the posterior dorsal root ganglion. Here, we aim to expand our knowledge by reporting three cases of associated zoster infection in COVID-19 patients admitted to our intensive care unit in view of respiratory complaints. All the three patients admitted, had revealed lymphocytopenia at the time of HZ diagnosis, and were managed conservatively throughout the course. In all the cases, acyclovir/valacyclovir led to the resolution of lesions in 10 days. No postherpetic sequelae were observed. We here suggest that the clinical presentation of HZ at the time of the current pandemic should be considered as an alarming sign for a latent subclinical SARS CoV-2 infection and thorough follow-up of such patients be adopted.

Clinical characteristics and outcomes of patients with Herpes Zoster Infection in the context of SARS-CoV-2 infection. A case report and a systematic review

“…Recently, there have been many reports on patients with features of skin rash after SARS-CoV-2 disease, which ranged from erythematous rash to chickenpox-like/urticarial eruption. 42 Although SARS-CoV-2-infected patients are reported to have presented with ample skin manifestations resembling the herpes virus, the lesions associated with SARS-CoV-2 disease were less itchy and mostly detected in the trunk and limbs and rarely on the face as compared to the typical localized dermatomal appearance of HZ. 43 Besides skin manifestations, few papers corroborated the VZV encephalitis, retinal necrosis, and cranial polyneuropathy.…”

Multidisciplinaridade em saúde: a necessidade da integração

“…A maior parte dos casos de herpes zoster em infecção concorrente ou ativados após a infecção ou tratamento da COVID-19 tiveram apresentações clínicas típicas da doença, com lesões na face ou oftálmico, pescoço, tronco ou membros, geralmente unilateral e com comprometimento de um só dermatoma (BRAMBRILA et al, 2020;ELSAIE & NADA, 2020;ELSAIE et al, 2020;NOFAL et al, 2020;XU et al, 2020;CAO et al, 2020;FERREIRA et al, 2020;PONA et al, 2020;SAATI et al, 2020;FERNANDEZ-NIETO et al, 2020;TARTATI et al, 2020;MARZANO et al, 2021;AU et al, 2021;GHOSH et al, 2021;DESAI et al, 2021;LOH et al, 2021;FARUK & RAHMAN, 2021, PÉREZ-BEJARANO et al, 2021ALTAF, 2021;PURI et al, 2021), embora formas atípicas ou mais graves como herpes zoster disseminado (VORSIN et al, A reunião de diversos fatores sociais, psicológicos, fisiológicos, na condução clínica da COVID-19 e no espectro vacinal que desencadeiam a manifestação do herpes zoster no contexto da COVID-19 impinge a uma análise sob a ótica da sindemia para ambas as doenças. A avaliação do cenário de saúde através de uma abordagem mais ampla é o único meio para estimar a real extensão e interrelação entre essas viroses na conjuntura da atual.…”