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

Frontiers in Medicine

article

Parnian Jamshidi¹  Bahareh Hajikhani²  Mehdi Mirsaeidi³  Hassan Vahidnezhad⁴  Masoud Dadashi⁵  Mohammad Javad Nasiri² 

[1] Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences;Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences;Division of Pulmonary and Critical Care, University of Miami, United States;Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, United States;Department of Microbiology, School of Medicine, Alborz University of Medical Sciences

关键词: COVID-19;    coronavirus;    COVID-19;    skin manifestations;    skin;    pathology;    systematic literature search;    disease severity;    mortality;    prognosis;   

DOI  :  10.3389/fmed.2021.634208

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

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.

【 授权许可】

CC BY