The use of Google Trends for acral symptoms during COVID‐19 outbreak in France

Kluger, Nicolas; Scrivener, Y

doi:10.1111/jdv.16572

Cited by 19 publications

(28 citation statements)

References 7 publications

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“…14,15,17,19,22 To date, a limited number of patients underwent SARS-CoV-2 testing. 9,[11][12][13][14][15][16][17][18][19][20][21][22] Interestingly in 3 reported patients with confirmed COVID-19 infection, cutaneous manifestations started 17 to 28 days after COVID-19 symptoms, 21 indicating that chilblain-like lesions can appear late in disease course, as also suggested by our patient history. SARS-Cov2 testing by real-time RT-PCR on nasopharyngeal swabs and, in three cases, on skin biopsy proved negative in all our patients.…”

Section: Discussionsupporting

confidence: 74%

“…[7][8][9] In addition to vesicular or maculopapular skin rashes, livedoid/necrotic lesions and urticaria, chilblainslike lesions are increasingly reported in particular in adolescents and young adults. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] We also observed from last March an unusual number of patients, mainly teenagers, affected with chilblains-like lesions. Thus, we decided to investigate the aetiology of these lesions and possible relationship with COVID-19 infection in our patients.…”

Section: Introductionmentioning

confidence: 51%

“…Chilblain-like lesions are being increasingly reported in different European and non-European countries during COVID-19 pandemic. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Indeed, first case series on skin manifestations during COVID-19 outbreak indicate that acral lesions are quite frequent: they were present in 106 of 277 dermatological outpatients (38.3%) in a French retrospective study 22 and in 79 of 375 cases (21%) in a Spanish prospective survey. 9 Therefore, we decided to undertake a systematic study of clinical, capillaroscopic, histopathological and SARS-CoV-2 infection in paediatric patients referred to us for this peculiar skin manifestation, in order to investigate a possible relationship with COVID-19 infection.…”

Section: Discussionmentioning

confidence: 99%

“…All patients were Italian and lived in Lazio Region (Central Italy). There was a predominance of male patients (M:F = 2.8: 1); the mean age was 14.0 years (range, [11][12][13][14][15][16][17]. Two patients were siblings.…”

Section: Clinical Featuresmentioning

confidence: 99%

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A clinical, histopathological and laboratory study of 19 consecutive Italian paediatric patients with chilblain‐like lesions: lights and shadows on the relationship with COVID‐19 infection

Hachem

Diociaiuti

Concato

et al. 2020

Acad Dermatol Venereol

131

226

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Background Acral chilblain-like lesions are being increasingly reported during COVID-19 pandemic. However, only few patients proved positivity for SARS-CoV-2 infection. The relationship between this skin manifestation and COVID-19 infection has not been clarified yet. Objective To thoroughly characterize a prospective group of patients with chilblain-like lesions and to investigate the possible relationship with SARS-CoV-2 infection. Methods Following informed consent, patients underwent (i) clinical evaluation, (ii) RT-PCR and serology testing for SARS-CoV-2, (iii) digital videocapillaroscopy of finger and toe nailfolds, (iv) blood testing to screen for autoimmune diseases and coagulation anomalies, and (v) skin biopsy for histopathology, direct immunofluorescence and, in selected cases, electron microscopy. Results Nineteen patients, all adolescents (mean age: 14 years), were recruited. 11/19 (58%) of them and/or their cohabitants reported flu-like symptoms one to two months prior to skin manifestation onset. Lesions were localized to toes and also heels and soles. Videocapillaroscopy showed pericapillary oedema, dilated and abnormal capillaries, and microhaemorrhages both in finger and toe in the majority of patients. Major pathological findings included epidermal basal layer vacuolation, papillary dermis oedema and erythrocyte extravasation, perivascular and perieccrine dermal lymphocytic infiltrate, and mucin deposition in the dermis and hypodermis; dermal vessel thrombi were observed in two cases. Blood examinations were normal. Nasopharyngeal swab for SARS-CoV-2 and IgG serology for SARS-CoV-2 nucleocapsid protein were negative. Importantly, IgA serology for S1 domain of SARS-CoV-2 spike protein was positive in 6 patients and borderline in 3. Conclusions Chilblain-like lesions during COVID-19 pandemic have specific epidemiologic, clinical, capillaroscopic and histopathological characteristics, which distinguish them from idiopathic perniosis. Though we could not formally prove SARS-CoV-2 infection in our patients, history data and the detection of anti-SARS-COV-2 IgA strongly suggest a relationship between skin lesions and COVID-19. Further investigations on the mechanisms of SARS-CoV-2 infection in children and pathogenesis of chilblain-like lesions are warranted.

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Section: Discussionsupporting

confidence: 74%

Section: Introductionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Section: Clinical Featuresmentioning

confidence: 99%

See 2 more Smart Citations

A clinical, histopathological and laboratory study of 19 consecutive Italian paediatric patients with chilblain‐like lesions: lights and shadows on the relationship with COVID‐19 infection

Hachem

Diociaiuti

Concato

et al. 2020

Acad Dermatol Venereol

131

226

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“…Pseudo-pernio (PP) is the skin lesion most frequently found in COVID-19 patients, according to Kluger et al, but the real incidence remains unknown. 41 The way these lesions are named can be controversial. We have used a doctor´s consensus to describe four clinical patterns but, unfortunately, there is no common terminology in the literature.…”

Section: Discussionmentioning

confidence: 99%

<p>Incidence, Characteristics, Laboratory Findings and Outcomes in Acro-Ischemia in COVID-19 Patients</p>

Alonso¹,

Mata-Forte²,

García-León³

et al. 2020

VHRM

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Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/EQDtTCBSFOI Aim: In addition to its respiratory impact of SARS-CoV2, skin lesions of probable vascular origin have been described. This study intends to quantify the incidence of acro-ischemic lesions in COVID-19 infected adult subjects in our population, describing clinical patterns and associated findings. Methods: All adult confirmed cases of COVID-19 infection who presented with acroischemic lesions and received care in our institution were prospectively enrolled up to May 15th, 2020. The variables included demographics, comorbidities, analytical parameters, clinical presentations and COVID-19 treatment. Results: We enrolled 24 patients. The overall rate of acro-ischemic findings in COVID-19 patients was 1.2% [0.6% for outpatients and 2.9% for hospitalized (ICU and non-ICU patients)], but the observed incidence for acro-ischemia in ICU patients was remarkably higher (23.0%, p<0.001). We have described four different clinical patterns of acroischemia: atypical Raynaud´s phenomenon (ARP), (4); pseudo-pernio (PP), (5); severe microcirculatory ischemia with preserved pulse (SMI), (6); and dry gangrene with arteriosclerosis obliterans (AO), (9). Kendall´s τ correlation with lung disease severity was 0.877 (95% CI, 0.756 to 0.968); p<0.01). ARP individuals were predominantly female, while SMI appeared lately in elderly hospitalized subjects with better prognosis. AO occurred in patients with more comorbidity and younger than those with SMI. We observed other associated lesions of suggestive ischemic nature in other organs in all groups (15 patients of total sample). Plasma procalcitonin was significantly higher in patients who developed SMI (median and interquartile range: 9.99 (4.2, 12.3) mg/mL vs 0.26 (0.11, 0.89) mg/mL; p<0.001), and D-dimer level at hospital admission was significantly higher in AO patients (median and interquartile range: 1166 (1050, 2111) mg/L vs 502 (448, 777) mg/L; p<0.001). Conclusion: The observed risk for acroischemia in COVID-19 is high in ICU patients (23%). We have described four different clinical patterns of acroischemia (ARP, PP, SMI and AO) associated with lung disease severity. Authors have communicated various lesions of suggestive ischemic nature in other organs. Raynaud-like pattern is reported as a "novelty".

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Dermatological Manifestations of COVID-19 in Children

2022

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Context The clinical picture of pediatric severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection differs from adults as do the cutaneous manifestations. In this review, we summarize the varied morphological manifestations of SARS-CoV-2 infection in the pediatric population. Evidence acquisition A comprehensive literature search was conducted (23 September, 2021) across multiple databases (PubMed, EMBASE, MEDLINE and Cochrane) with the relevant keywords. An additional filter of age group between 0–18 years was kept in each of the searches. Results Chilblains constitute the most common cutaneous manifestation of pediatric coronavirus disease (COVID-19). Other commonly reported manifestations include maculopapular rash, urticaria, erythema multiforme, and papulovesicular eruptions. Majority of children with these manifestations are asymptomatic, highlighting the need to clinically suspect and appropriately manage such patients. A subset of pediatric patients develop severe multisystem involvement termed as multi-system inflammatory syndrome in children (MIS-C) that has varied mucocutaneous manifestations. Conclusion A wide variety of dermatological manifestation of SARS-CoV-2 infection is reported, and both the pediatrician and dermatologist need to be aware of the same to suspect and diagnose COVID-19 infection in children. Electronic Supplementary Material Supplementary material is available in the online version of this article at 10.1007/s13312-022-2521-6.

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The use of Google Trends for acral symptoms during COVID‐19 outbreak in France

Cited by 19 publications

References 7 publications

A clinical, histopathological and laboratory study of 19 consecutive Italian paediatric patients with chilblain‐like lesions: lights and shadows on the relationship with COVID‐19 infection

A clinical, histopathological and laboratory study of 19 consecutive Italian paediatric patients with chilblain‐like lesions: lights and shadows on the relationship with COVID‐19 infection

<p>Incidence, Characteristics, Laboratory Findings and Outcomes in Acro-Ischemia in COVID-19 Patients</p>

Dermatological Manifestations of COVID-19 in Children

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