Silent COVID-19: what your skin can reveal

Guarneri, Claudio; Rullo, Emmanuele Venanzi; Pavone, Piero; Berretta, Massimiliano; Ceccarelli, Manuela; Natale, Alfonso; Nunnari, Giuseppe

doi:10.1016/s1473-3099(20)30402-3

Cited by 65 publications

(69 citation statements)

References 3 publications

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“…The varied cutaneous presentations, histopathological ndings, and other details are tabulated in table 3. Reference [16], [19], [20], [21], [24], [25], [26], [27] [17], [18], [ The majority of the children showed erythematous maculopapular eruptions, which is generally the commonest cutaneous presentation in any viral illness, however, a closer look in our study subjects throws up several contradicting observations. For instance, instead of general cephalocaudal distribution in any viral exanthem, here the cases showed involvement of acral region of feet and hands.…”

Section: Resultsmentioning

confidence: 87%

“…[11], [12] [13], [14] [15] Thus, a total of 13 articles met the inclusion criteria and were systematically reviewed. Out of that 5 were case series, [16], [17] [18], [19] [20] 4 were case reports, [21], [22] [23], [24] and 4 were original studies. [25], [26] [27], [28] Maximum number of articles were reported from Italy, [16], [19] [20], [21] [22], [24] [26] followed by Spain, [17] [23], [25] France, [8] Turkey, [28] and USA.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 149 different patients were analyzed & discussed. The youngest case is of 8 months female baby (28) and the oldest is an18-year male [19] with the mean patient age at 11.096 years (SD±4.56 years) Males comprised 85 cases (57%) while females accounted for 64 cases (43 %). Acrally located erythematous to violaceous maculopapular lesion having blurred edges, occasionally with super cial bullae and focal hemorrhagic crust was the most common nding in 127 children.…”

Section: Resultsmentioning

confidence: 99%

“…[16], [20], [24], [25], [26] A similar but larger lesion as erythematous to purpuric plaques with occasional macules was reported in 11 cases. [16], [19] [21], [27] Erythema multiforme like lesion observed in 6 cases, consisted of target and targetoid, con uent macules, papules and plaques of different sizes, few with bleeding and crust at the center with the involvement of conjunctiva in one and mucous membrane in one patient each. [17] [18], [23] Bilaterally symmetrical varicella like exanthem presented as erythematous papules & vesicles with super cial vesiculation & crust formation, on the trunk, in an 8-year female child.…”

Section: Resultsmentioning

confidence: 99%

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Cutaneous manifestations associated with COVID-19 in children: A Systematic Review

Shah

Akhade

Ganguly

et al. 2020

Preprint

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Background: Cutaneous manifestation of COVID 19 in children has not yet been reviewed systematically and hence this review gives a future direction to the clinicians to be vigilant for skin presentations during such pandemic.Methodology: The review was done as per the guidelines of PRISMA and literature search was done on PubMed database using keywords as COVID-19, children and skin in different combinations. Articles published in English with cases of age 1 month to 18 years were eligible. The outcome included varied aspects of cutaneous and COVID-19 infection. The review protocol was not registered.Results: Of 51 publications identified, 13 studies containing 149 children met the eligibility criteria. Acrally located erythematous maculopapular lesion was the most common finding in 138 children. Erythema multiforme, varicella like exanthem and Kawasaki disease like presentations were reported in the rest of the cases. The duration of the skin lesion was 1-2 weeks in 43%. Skin biopsy done in 18 cases revealed superficial & deep perivascular and peri-eccrine lymphocytic infiltrate & lymphocytic vasculitis. RT-PCR was positive in 13.8% cases. Serological markers for HSV, parvovirus B19 analyzed across various studies, were found negative, except for mycoplasma pneumoniae in 2 of 20 cases tested.Discussion: Clinicopathologic analysis established chilblains like lesion in 43% cases with no confirmed etiology like cold exposure, autoimmune dysfunction, drug reaction, or viral infection. The usual cephalo-caudal spread of a viral exanthem was also missing. However, a low number of discussed cases was a limitation of the study.Conclusion: In the absence of any confirmed etiology for such cutaneous manifestations, the possibility of COVID-19 should be explored and evaluated thoroughly during such pandemic.

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Section: Resultsmentioning

confidence: 87%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Cutaneous manifestations associated with COVID-19 in children: A Systematic Review

Shah

Akhade

Ganguly

et al. 2020

Preprint

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“…The ongoing COVID-19 pandemic caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is rapidly developing [ 2 ]. COVID-19 is caused by a virus, SARS-COV-2, and its major symptoms are fever, cough, and dyspnea, and minor symptoms are alteration of the smell and taste, gastrointestinal symptoms, headache, and cutaneous manifestations [ 3 – 5 ]. SARS-CoV-2 enters cells through the angiotensin converting enzyme 2 (ACE2) which is its intended receptor [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

A meta-analysis of the impact of COVID-19 on liver dysfunction

Yang

2020

Eur J Med Res

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Background The novel coronavirus disease 2019 (COVID-19), which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is leading to a worldwide pandemic. Except representative manifestation of pneumonia and acute respiratory symptoms, COVID-19 patients have also shown different levels of liver injury or liver dysfunction. The aim of our study was to explore the probable clinical severity and mortality of COVID-19 patients and their liver dysfunction. Method A combination of computer and manual retrieval was used to search in Medline through PubMed, EMBASE and Web of Science. Review Manager 5.3 software was used to examine the heterogeneity among the studies and to calculate the combined effect value (OR, 95CI). Subgroup analysis, sensitivity analysis, and publication bias test were also performed. Results We found a significant connection between liver dysfunction and mortality of COVID-19 patients with a pooled OR of 1.98 (95% CI 1.39–2.82; P = 0.0002). There was a significant association between AST and severity of COVID-19 with a pooled OR of 4.48 (95% CI 3.24–7.21; P < 0.001), and a pooled WMD of 3.35 (95% CI, 2.07 to 4.64; P < 0.001). In addition, there was a significant difference between TBIL and severity of COVID-19, with a pooled OR of 1.91 (95% CI 1.40–2.60; P < 0.001), and with a pooled WMD of 1.18 (95% CI, 0.78 to 1.58; P < 0.001). Conclusion The mortality and severity of COVID-19 patients are significantly associated with liver dysfunction. The non-survivors and severe COVID-19 patients have elevated serum AST levels than the survivors and non-severe COVID-19 patients. The results of this study form a basis for better clinical liver management of patients with COVID-19.

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Reproductive Effects of COVID-19: A Journey Through COVID-19 Pathogenesis

Shoupe

2023

Handbook of Gynecology

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Silent COVID-19: what your skin can reveal

Cited by 65 publications

References 3 publications

Cutaneous manifestations associated with COVID-19 in children: A Systematic Review

Cutaneous manifestations associated with COVID-19 in children: A Systematic Review

A meta-analysis of the impact of COVID-19 on liver dysfunction

Reproductive Effects of COVID-19: A Journey Through COVID-19 Pathogenesis

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