Skin Manifestations in COVID-19 Patients: Are They Indicators for Disease Severity? A Systematic Review

Introduction: Until now, there are several reports on cutaneous manifestations in COVID-19 patients. However, the link between skin manifestations and the severity of the disease remains debatable. We conducted a systematic review to evaluate the temporal relationship between different types of skin...

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Vydáno v:Frontiers in medicine Ročník 8; s. 634208
Hlavní autoři: Jamshidi, Parnian, Hajikhani, Bahareh, Mirsaeidi, Mehdi, Vahidnezhad, Hassan, Dadashi, Masoud, Nasiri, Mohammad Javad
Médium: Journal Article
Jazyk:angličtina
Vydáno: Switzerland Frontiers Media SA 16.02.2021
Frontiers Media S.A
Témata:
Case reports
coronavirus – COVID-19
COVID-19
disease severity
Lesions
Medicine
Pandemics
Patients
Severe acute respiratory syndrome coronavirus 2
skin - pathology
skin manifestations
systematic literature search
Systematic review
Urticaria
Turkey
Singapore
Belgium
United States > US
China
Italy
Thailand
Kuwait
France
Russia
Spain
Indonesia
COVID-19
skin manifestations
mortality
skin - pathology
systematic literature search
coronavirus – COVID-19
disease severity
prognosis
ISSN:2296-858X, 2296-858X
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Shrnutí:Introduction: Until now, there are several reports on cutaneous manifestations in COVID-19 patients. However, the link between skin manifestations and the severity of the disease remains debatable. We conducted a systematic review to evaluate the temporal relationship between different types of skin lesions and the severity of COVID-19. Methods: A systematic search was conducted for relevant studies published between January and July 2020 using Pubmed/Medline, Embase, and Web of knowledge. The following keywords were used: “SARS-CoV-2” or “COVID-19” or “new coronavirus” or “Wuhan Coronavirus” or “coronavirus disease 2019” and “skin disease” or “skin manifestation” or “cutaneous manifestation.” Results: Out of 381 articles, 47 meet the inclusion criteria and a total of 1,847 patients with confirmed COVID-19 were examined. The overall frequency of cutaneous manifestations in COVID-19 patients was 5.95%. The maculopapular rash was the main reported skin involvement (37.3%) commonly occurred in middle-aged females with intermediate severity of the disease. Forty-eight percentage of the patients had a mild, 32% a moderate, and 20% a severe COVID-19 disease. The mild disease was mainly correlated with chilblain-like and urticaria-like lesions and patients with vascular lesions experienced a more severe disease. Seventy-two percentage of patients with chilblain-like lesions improved without any medication. The overall mortality rate was 4.5%. Patients with vascular lesions had the highest mortality rate (18.2%) and patients with urticaria-like lesions had the lowest mortality rate (2.2%). Conclusion: The mere occurrence of skin manifestations in COVID-19 patients is not an indicator for the disease severity, and it highly depends on the type of skin lesions. Chilblain-like and vascular lesions are the ends of a spectrum in which from chilblain-like to vascular lesions, the severity of the disease increases, and the patient's prognosis worsens. Those with vascular lesions should also be considered as high-priority patients for further medical care.
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Edited by: Zisis Kozlakidis, International Agency for Research on Cancer (IARC), France
This article was submitted to Infectious Diseases - Surveillance, Prevention and Treatment, a section of the journal Frontiers in Medicine
Reviewed by: Dayi Zhang, Tsinghua University, China; Sunny Oteikwu Ochigbo, University of Calabar, Nigeria
ISSN:2296-858X
2296-858X
DOI:10.3389/fmed.2021.634208