1
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de Aguiar BRL, Ferreira EB, De Luca Canto G, Guerra ENS, Dos Reis PED. Prevalence of skin manifestations in patients with COVID-19: a systematic review and meta-analysis. Front Med (Lausanne) 2024; 11:1390775. [PMID: 39234048 PMCID: PMC11371801 DOI: 10.3389/fmed.2024.1390775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 08/07/2024] [Indexed: 09/06/2024] Open
Abstract
Background COVID-19 presents extrapulmonary manifestations that can aid in the diagnosis. Skin manifestations have been reported but their characteristics are not yet clear. Health professionals need information about its prevalence and main characteristics. Methods This systematic review followed the PRISMA criteria. The protocol was registered in the PROSPERO (number CRD42020193173). Seven electronic databases and the gray literature were searched independently by two researchers. Observational analytical studies that presented data on the prevalence of skin manifestations in patients aged 19 or older with COVID-19 were included. Prevalence estimates were synthesized through a meta-analysis using random-effects models. Association meta-analysis and comparisons were performed for individual characteristics. Results We included 31 studies with 10,934 patients, of which 10,121 tested positive for COVID-19. The general prevalence of skin manifestations was 29% (95% CI: 17.0-43.0; I2: 99%), the most in Africa, with a mean duration between 7 and 9 days and the most frequently affecting feet+hands (75%) and the trunk (71%). Patients with mild/moderate COVID-19 had more of chilblain-like+pernio-like lesions (97%) and inflammatory lesions (86%) than patients with severe or critical COVID-19. Manifestations of vascular origin were only in elderly patients and were significant with the severity of COVID-19 (p = 0). Conclusion The global prevalence of skin manifestations is similar to other signs and symptoms of COVID-19. Skin assessment should be considered when investigating and diagnosing COVID-19 in adult and elderly patients.Systematic review registration: PROSPERO, identifier CRD42020193173, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020193173.
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Affiliation(s)
- Beatriz Regina Lima de Aguiar
- Health Science Graduate Program, School of Health Sciences, University of Brasilia, Brasília, Brazil
- Interdisciplinary Laboratory of Research Applied to Clinical Practice in Oncology, School of Health Sciences, University of Brasilia, Brasília, Brazil
| | - Elaine Barros Ferreira
- Interdisciplinary Laboratory of Research Applied to Clinical Practice in Oncology, School of Health Sciences, University of Brasilia, Brasília, Brazil
| | - Graziela De Luca Canto
- Department of Dentistry, Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Eliete Neves Silva Guerra
- Health Science Graduate Program, School of Health Sciences, University of Brasilia, Brasília, Brazil
- Interdisciplinary Laboratory of Research Applied to Clinical Practice in Oncology, School of Health Sciences, University of Brasilia, Brasília, Brazil
- Laboratory of Oral Histopathology, School of Health Sciences, University of Brasilia, Brasília, Brazil
| | - Paula Elaine Diniz Dos Reis
- Health Science Graduate Program, School of Health Sciences, University of Brasilia, Brasília, Brazil
- Interdisciplinary Laboratory of Research Applied to Clinical Practice in Oncology, School of Health Sciences, University of Brasilia, Brasília, Brazil
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2
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Santos MG, Gabuyo AKV. COVID-19 Infection Manifesting with Maculopapular Rash: A Case Report. ACTA MEDICA PHILIPPINA 2024; 58:87-91. [PMID: 39166227 PMCID: PMC11330998 DOI: 10.47895/amp.v58i13.8092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/22/2024]
Abstract
COVID-19 commonly manifests with respiratory symptoms but is reported to involve other organs including the skin. This is a case of a 58-year-old male diagnosed with mild COVID-19 infection via reverse transcriptase-polymerase chain reaction (RT-PCR) nasopharyngeal swab (NPS). He initially presented with symptoms of fever, cough, colds, sore throat, anosmia, ageusia, myalgia, and diarrhea. Maculopapular cutaneous lesions appeared on the extremities on the 3rd day of illness and were described as pruritic and blanching. The patient was managed conservatively with oral hydration and vitamin supplementation. During home isolation, symptoms were monitored via telemedicine. He recovered and was asymptomatic 36 days from the onset of symptoms. During the early part of the pandemic, further diagnostic testing was challenging due to the restrictions that were implemented. However, careful history, modified physical examination, and monitoring through teleconsultation proved to be very useful. Documenting the course and outcome of COVID-19 patients with skin manifestations would help facilitate timely diagnosis and treatment, as well as anticipate the possible prognosis of patients who present with a similar clinical pattern.
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Affiliation(s)
- Maricar G Santos
- Department of Family and Community Medicine, Philippine General Hospital, University of the Philippines Manila
| | - Am Karoline V Gabuyo
- Department of Family and Community Medicine, Philippine General Hospital, University of the Philippines Manila
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3
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Liu Y, Xu Z, Zhou J, Chen A, Zhang J, Kang X, Jiang X, Lyu C, Shi C, Shi Y, Liu X, Li F, Yang B, Huang Y, Yu C, Wang G. Clinical characteristics and outcomes of psoriasis patients with COVID-19: A retrospective, multicenter cohort study in China. Chin Med J (Engl) 2024; 137:1736-1743. [PMID: 38710539 PMCID: PMC11268825 DOI: 10.1097/cm9.0000000000003024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Limited information exists regarding the impact of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection on psoriasis patients. The objective of this study was to identify clinical factors associated with the prognosis of psoriasis following SARS-CoV-2 infection. METHODS A retrospective, multicenter study was conducted between March and May 2023. Univariable and multivariable logistic regression analyses were employed to identify factors associated with coronavirus disease 2019 (COVID-19)-related psoriasis outcomes. The study included 2371 psoriasis patients from 12 clinical centers, with 2049 of them having been infected with SARS-CoV-2. RESULTS Among the infected groups, lower exacerbation rates were observed in individuals treated with biologics compared to those receiving traditional systemic or nonsystemic treatments (22.3% [236/1058] vs . 39.8% [92/231] vs . 37.5% [140/373], P <0.001). Psoriasis progression with lesions (adjusted odds ratio [OR] = 8.197, 95% confidence interval [95% CI] = 5.685-11.820, compared to no lesions), hypertension (adjusted OR = 1.582, 95% CI = 1.068-2.343), traditional systemic (adjusted OR = 1.887, 95% CI = 1.263-2.818), and nonsystemic treatment (adjusted OR = 1.602, 95% CI = 1.117-2.297) were found to be associated with exacerbation of psoriasis after SARS-CoV-2 infection, but not biologics (adjusted OR = 0.931, 95% CI = 0.680-1.274, compared to no treatment), according to multivariable logistic regression analysis. CONCLUSIONS A reduced risk of psoriasis exacerbation after SARS-CoV-2 infection was observed with biologics compared to traditional systemic and nonsystemic treatments. Significant risk factors for exacerbation after infection were identified as existing psoriatic lesions and hypertension. TRIAL REGISTRATION ClinicalTrials.gov (No. NCT05961605).
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Affiliation(s)
- Yanhua Liu
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi 710032, China
| | - Zhongrui Xu
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi 710032, China
| | - Jian Zhou
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi 710032, China
| | - Aijun Chen
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Junling Zhang
- Department of Dermatology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin 300072, China
| | - Xiaojing Kang
- Department of Dermatology and Venereology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang 830001, China
| | - Xian Jiang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Chengzhi Lyu
- Department of Psoriasis, Dalian Dermatosis Hospital, Dalian, Liaoning 116011, China
| | - Chunrui Shi
- Department of Dermatology, The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, China
| | - Yuling Shi
- Skin Disease Hospital of Tongji University, Shanghai 200050, China
| | - Xiaoming Liu
- Department of Dermatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong 518053, China
| | - Fuqiu Li
- Department of Dermatology, The Second Hospital of Jilin University, Changchun, Jilin 130000, China
| | - Bin Yang
- Department of Dermatology, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong 510091, China
| | - Yongmei Huang
- Department of Dermatology, Xining First People’s Hospital, Xining, Qinghai 810000, China
| | - Chen Yu
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi 710032, China
| | - Gang Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi 710032, China
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4
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Huang H, Guo Z, Chen D, Deng G. Editorial: The impact of the COVID-19 pandemic on dermatology patients: diagnosis, treatment, and prognosis. Front Med (Lausanne) 2024; 11:1418722. [PMID: 38756939 PMCID: PMC11096561 DOI: 10.3389/fmed.2024.1418722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/18/2024] Open
Affiliation(s)
- Huining Huang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, Hunan, China
- Furong Laboratory, Changsha, Hunan, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Ziyu Guo
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, Hunan, China
- Furong Laboratory, Changsha, Hunan, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Danyao Chen
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
- Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Guangtong Deng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, Hunan, China
- Furong Laboratory, Changsha, Hunan, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
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5
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Brambilla I, Bolcato V, Volonté M, Querzani A, Guarracino C, Tondina E, Marseglia GL, Brazzelli V. Lipschütz ulcers due to SARS-CoV-2 infection: a neglected diagnosis in emergency room. Int J Womens Dermatol 2024; 10:e122. [PMID: 38348354 PMCID: PMC10861013 DOI: 10.1097/jw9.0000000000000122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 10/23/2023] [Indexed: 02/15/2024] Open
Abstract
Background Primary acute genital ulcers, or Lipschütz ulcers (LU), are nonsexually transmitted, painful, self-limiting, nonrecurrent vulvar ulcers with unclear pathogenesis, representing a challenging diagnosis in emergency setting. LU have recently been described in association with severe acute respiratory syndrome coronaVirus 2 (SARS-CoV-2) infection and vaccination. Objective The aim of this study is to describe 2 cases of LU due to SARS-CoV-2 infection, highlighting the diagnostic process, differential diagnosis, disease course, and management options. Methods We describe 2 young females (12 and 9 years old) who presented to pediatric emergency room with the sudden onset of well-demarcated, painful, vulvar ulcers with fibrinous necrotic center. Results Both patients tested positive to SARS-CoV-2 nasal swab, and, at physical examination, no other lesions were found in other cutaneous or mucosal sites. Sexual abuse was excluded in both cases, as well as infectious and autoimmune diseases. Supportive analgesic therapy was administered, and complete remission of lesions was observed at follow-up visits without evidence of scarring. Limitations The main limitation of this work is represented by the small number of cases described. Conclusion Even though extremely rare, LU related to COVID-19 are an emerging entity to be considered in the diagnosis of acute genital ulcerations. Multidisciplinary diagnostic workup of genital ulcers must be established in order to exclude sexual child abuse, to ensure patient safety, and to avoid unnecessary treatment and familial anxiety.
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Affiliation(s)
- Ilaria Brambilla
- Department of Pediatrics, Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Vittorio Bolcato
- Department of Public Health, Experimental and Forensic Medicine, Fondazione Istituto Neurologico Nazionale C. Mondino I.R.C.C.S., Unit of Legal Medicine, Pavia, Italy
| | - Martina Volonté
- Department of Clinical, Surgical and Pediatric Sciences, Institute of Dermatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Querzani
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Università degli Studi di Pavia, Pavia, Italy
| | - Carmen Guarracino
- Department of Pediatrics, Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Enrico Tondina
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Università degli Studi di Pavia, Pavia, Italy
| | - Gian Luigi Marseglia
- Department of Pediatrics, Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Università degli Studi di Pavia, Pavia, Italy
| | - Valeria Brazzelli
- Department of Clinical, Surgical and Pediatric Sciences, Institute of Dermatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Università degli Studi di Pavia, Pavia, Italy
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6
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Didona D, Sequeira-Santos AM, Hinterseher J, Cunha T, Hertl M. Lichen planus pemphigoides after COVID-19 infection. J Eur Acad Dermatol Venereol 2024; 38:e131-e133. [PMID: 37793803 DOI: 10.1111/jdv.19542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 09/28/2023] [Indexed: 10/06/2023]
Affiliation(s)
- D Didona
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
| | | | - J Hinterseher
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
| | - T Cunha
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
| | - M Hertl
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
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7
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Ng CYJ, Bun HH, Zhao Y, Zhong LLD. TCM "medicine and food homology" in the management of post-COVID disorders. Front Immunol 2023; 14:1234307. [PMID: 37720220 PMCID: PMC10500073 DOI: 10.3389/fimmu.2023.1234307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/10/2023] [Indexed: 09/19/2023] Open
Abstract
Background The World Health Organization declared that COVID-19 is no longer a public health emergency of global concern on May 5, 2023. Post-COVID disorders are, however, becoming more common. Hence, there lies a growing need to develop safe and effective treatment measures to manage post-COVID disorders. Investigating the use of TCM medicinal foods in the long-term therapy of post-COVID illnesses may be beneficial given contemporary research's emphasis on the development of medicinal foods. Scope and approach The use of medicinal foods for the long-term treatment of post-COVID disorders is highlighted in this review. Following a discussion of the history of the TCM "Medicine and Food Homology" theory, the pathophysiological effects of post-COVID disorders will be briefly reviewed. An analysis of TCM medicinal foods and their functions in treating post-COVID disorders will then be provided before offering some insight into potential directions for future research and application. Key findings and discussion TCM medicinal foods can manage different aspects of post-COVID disorders. The use of medicinal foods in the long-term management of post-COVID illnesses may be a safe and efficient therapy choice because they are typically milder in nature than chronic drug use. These findings may also be applied in the long-term post-disease treatment of similar respiratory disorders.
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Affiliation(s)
- Chester Yan Jie Ng
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
| | - Hung Hung Bun
- The University of Hong Kong (HKU) School of Professional and Continuing Education, Hong Kong, Hong Kong SAR, China
| | - Yan Zhao
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
| | - Linda L. D. Zhong
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Hong Kong, Hong Kong SAR, China
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8
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The Pandemic and Your Skin—Direct and Indirect Impact of COVID-19. COSMETICS 2023. [DOI: 10.3390/cosmetics10010034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
Apart from well-known respiratory symptoms, less frequent symptoms also appear as a direct result of COVID-19 infection, or as indirect effects of the recommended quarantine and related lifestyle changes. The impact of the COVID-19 pandemic on human skin is predominantly focused on in this article. Cutaneous manifestations, including redness, chilblain-like symptoms (COVID toes), hives or urticaria rash, water blisters, and fishing net-like red-blue patterns on the skin, may appear as accompanying or as systemic COVID-19 symptoms with potential lesions at different skin sites. These symptoms were related to skin phototypes and vitamin D deficiency. Moreover, Black, Asian, and minority ethnic origin patients are found to be more sensitive to COVID-19 infection than Caucasians because of vitamin D deficiency. The region of population with lighter skin phototypes have a significantly higher chance to develop cutaneous manifestations than population with dark skin. In addition, adverse effects, such as skin barrier damage and irritation, may also occur due to extensive personal protective equipment usage (e.g., masks, protective suits, and a few others) and predominately alcohol-based sanitizers. This manuscript covers various aspects of COVID-19 and its clinical skin manifestations.
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9
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Nowack N, Skaletz-Rorowski A, Potthoff A. [Sexually transmitted infections under the influence of the COVID-19 pandemic]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023; 74:129-136. [PMID: 36688954 PMCID: PMC9869301 DOI: 10.1007/s00105-022-05099-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 01/24/2023]
Abstract
Sexually transmitted infections (STI) in Germany are constantly rising. STI screening and testing decreased during the coronavirus disease 2019 (COVID-19) pandemic due to redistribution of public health resources. During the pandemic, there was a decline in the diagnosis of STIs. A minor aspect of this could be explained by reductions in the number of sexual contacts and therefore actual reduced infections, but the greater aspect seems to be due to underdiagnosis. A dramatic surge of infections is expected in the next few years. It is of utmost importance to resume STI screening for early detection and treatment and thereby lowering the transmission of STIs.
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Affiliation(s)
- Nico Nowack
- WIR - Walk In Ruhr, Zentrum für Sexuelle Gesundheit und Medizin, St. Elisabeth-Hospital Bochum, Ruhr-Universität Bochum, Große Beckstr. 12, 44787, Bochum, Deutschland
- Interdisziplinäre Immunologische Ambulanz, Zentrum für Sexuelle Gesundheit und Medizin, Klinik für Dermatologie, Venerologie und Allergologie, Ruhr-Universität Bochum, Bochum, Deutschland
| | - Adriane Skaletz-Rorowski
- WIR - Walk In Ruhr, Zentrum für Sexuelle Gesundheit und Medizin, St. Elisabeth-Hospital Bochum, Ruhr-Universität Bochum, Große Beckstr. 12, 44787, Bochum, Deutschland
- Interdisziplinäre Immunologische Ambulanz, Zentrum für Sexuelle Gesundheit und Medizin, Klinik für Dermatologie, Venerologie und Allergologie, Ruhr-Universität Bochum, Bochum, Deutschland
| | - Anja Potthoff
- WIR - Walk In Ruhr, Zentrum für Sexuelle Gesundheit und Medizin, St. Elisabeth-Hospital Bochum, Ruhr-Universität Bochum, Große Beckstr. 12, 44787, Bochum, Deutschland.
- Interdisziplinäre Immunologische Ambulanz, Zentrum für Sexuelle Gesundheit und Medizin, Klinik für Dermatologie, Venerologie und Allergologie, Ruhr-Universität Bochum, Bochum, Deutschland.
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10
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Yusharyahya SN, Japranata VV, Jonlean R, Legiawati L, Astriningrum R. Cutaneous manifestations in elderly patients with confirmed coronavirus disease 2019 and the disease outcomes: A systematic review. J Dermatol 2023; 50:679-691. [PMID: 36680396 DOI: 10.1111/1346-8138.16722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/14/2022] [Accepted: 01/02/2023] [Indexed: 01/22/2023]
Abstract
Cutaneous manifestations in coronavirus disease 2019 (COVID-19) patients may possess prognostic value for identifying potentially severe cases. This systematic review investigated whether dermatological features are associated with COVID-19 outcomes in elderly patients. Literature retrieval was conducted on May 11, 2022, from databases, hand-searching, and tracing citations. Following selection against eligibility criteria, the remaining records were evaluated utilizing the National Heart, Lung, and Blood Institute Study Quality Assessment Tool or Newcastle-Ottawa Scale. The pooled individual data were subsequently analyzed using the Cochran-Mantel-Haenszel test to calculate the odds ratio (ORs) and confidence intervals (CIs) for the severity and mortality of each skin lesion type. We incorporated 70 articles, including 180 and 117 entries, with information regarding disease severity and mortality. Further analysis revealed that vascular type was the skin lesion most frequently noticed in confirmed COVID-19 elderly patients (46.2%) and was associated with an increased risk of developing advanced disease (OR 7.32, 95% CI 3.39-15.81) and the ensuing termination (OR 5.73, 95% CI 2.46-13.36). The converse phenomenon was observed in maculopapular type (severity OR 0.27, 95% CI 0.14-0.52; mortality OR 0.10, 95% CI 0.03-0.36). In conclusion, skin manifestations may predict COVID-19 severity and mortality in the senior group.
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Affiliation(s)
- Shannaz Nadia Yusharyahya
- Division of Geriatric Dermatology, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia-dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | | | | | - Lili Legiawati
- Division of Geriatric Dermatology, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia-dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Rinadewi Astriningrum
- Division of Geriatric Dermatology, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia-dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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11
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Chomičienė A, Černiauskas K, Linauskienė K, Meškauskas R, Malinauskienė L. Two case reports of skin vasculitis following the COVID-19 immunization. Open Med (Wars) 2022; 17:1944-1948. [PMID: 36561846 PMCID: PMC9743192 DOI: 10.1515/med-2022-0608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 12/14/2022] Open
Abstract
The coronavirus 2019 (COVID-19) disease is now responsible for one of the most challenging and concerning pandemics. Since December 2020, the world has had access to COVID-19 prophylaxis; thus, we encounter adverse events from vaccination more often due to the vast vaccination range. We present two case reports of difficult-to-treat skin vasculitis due to COVID-19 vaccination that were successfully treated in a tertiary-level university hospital. When encountering systemic treatment, resistant skin vasculitis plasmapheresis could be a choice of treatment.
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Affiliation(s)
- Anželika Chomičienė
- Vilnius University, Medical Faculty, Institute of Clinical Medicine, Clinic of Chest Diseases, Immunology and Allergology, Department of Pulmonology and Allergology, Vilnius, Lithuania
| | - Kęstutis Černiauskas
- Vilnius University, Medical Faculty, Institute of Clinical Medicine, Clinic of Chest Diseases, Immunology and Allergology, Department of Pulmonology and Allergology, Vilnius, Lithuania
| | - Kotryna Linauskienė
- Vilnius University, Medical Faculty, Institute of Clinical Medicine, Clinic of Chest Diseases, Immunology and Allergology, Department of Pulmonology and Allergology, Vilnius, Lithuania,Vilnius University Hospital Santaros Klinikos, Department of Pulmonology and Allergology, Santariškių Str. 2, Vilnius LT-08661, Lithuania
| | - Raimundas Meškauskas
- Pathology Department, National Center of Pathology, Affiliate of Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Laura Malinauskienė
- Vilnius University, Medical Faculty, Institute of Clinical Medicine, Clinic of Chest Diseases, Immunology and Allergology, Department of Pulmonology and Allergology, Vilnius, Lithuania
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12
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Durusu I, Gurel G, Tokyol C. [Translated article] A Case of Pityriasis Lichenoides Chronica in a Patient With COVID-19 Infection. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113 Suppl 1:TS18-TS19. [PMID: 36228711 PMCID: PMC9549708 DOI: 10.1016/j.ad.2022.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/15/2021] [Indexed: 12/25/2022] Open
Affiliation(s)
- I.N. Durusu
- Department of Dermatology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey,Corresponding author
| | - G. Gurel
- Department of Dermatology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - C. Tokyol
- Department of Pathology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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13
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Lee J, Kwon KH. Future perspective safe cosmetics: Focused on associated with ISO natural organic index. J Cosmet Dermatol 2022; 21:6619-6627. [PMID: 36120804 DOI: 10.1111/jocd.15398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/16/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND As we enter the era of long COVID, recent studies on the relationship between coronavirus disease-19 (COVID-19) and skin are being conducted from various angles. Awareness of the safety of healthy skin is increasing. OBJECTIVES Therefore, in this study, we empirically analyzed safe cosmetics, natural cosmetics, and organic cosmetics, which have recently become a critical issue. METHODS Keywords such as 'long COVID', 'COVID-19 Skin', 'ISO Natural Organic Index', 'edible', 'safe cosmetics', 'natural cosmetics', and 'organic cosmetics' were searched and created. This study was conducted using PubMed, Google Scholar, Riss, Scopus, and ResearchGate. Accordingly, a total of 689 papers were studied. This paper was successfully completed using a total of 41 references in this study using PRISMA flow diagram. RESULTS In the long COVID era, customers in the beauty and cosmetics market will have to apply ISO natural organic ingredients to the cosmetics and beauty industry, reflecting consumer demand for edible ingredients for safety issues. Therefore, it will be able to provide new strategy and implications for a safer cosmetic market that values health and beauty. CONCLUSION Therefore, in this literature review, interest in skin has increased due to the long corona, and it was determined that changes in the cosmetic market would be necessary by using the ISO natural organic index for the consumer's desire for healthy skin. Therefore, in this article, in the future development of eco-friendly organic cosmetics, in line with the natural and environment-friendly changes reminiscent of the efficacy or ingredients of products, it is necessary to develop cosmetics using the ISO natural organic index that meets the needs of consumers and a differentiated strategy.
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Affiliation(s)
- Jinkyung Lee
- Division of Beauty Arts Care, Department of Beauty Arts Care, Graduate School, Dongguk University, Seoul, Republic of Korea.,Department of Beauty and Health Care, Namseoul University, Cheonan, Republic of Korea
| | - Ki Han Kwon
- College of General Education, Kookmin University, Seoul, Republic of Korea
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14
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Durusu IN, Gurel G, Tokyol C. [A Case of Pityriasis Lichenoides Chronica in a Patient with COVID-19 Infection]. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:S18-S19. [PMID: 34602615 PMCID: PMC8479383 DOI: 10.1016/j.ad.2021.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/15/2021] [Indexed: 12/30/2022] Open
Affiliation(s)
- I N Durusu
- Department of Dermatology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turquía
| | - G Gurel
- Department of Dermatology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turquía
| | - C Tokyol
- Department of Pathology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turquía
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15
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Himed S, Gray A, Awethe Z, Libson K, Kaffenberger BH, Korman AM, Trinidad JCL. SARS-CoV-2 Infection and Vaccination Cutaneous Manifestations for the Inpatient Dermatologist. CURRENT DERMATOLOGY REPORTS 2022; 11:252-262. [PMID: 36274753 PMCID: PMC9579541 DOI: 10.1007/s13671-022-00374-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2022] [Indexed: 11/26/2022]
Abstract
Purpose of Review The overall purpose of this review was to characterize and summarize cutaneous eruptions associated with coronavirus disease 2019 (COVID-19) as well as COVID-19 vaccination. Recent Findings Cutaneous eruptions associated with COVID-19 infection have a reported frequency of 1-20%. Increased COVID-19 disease severity has been associated with morbilliform exanthems, urticaria, retiform purpura, and livedo racemosa. Papulovesicular eruptions were associated with a milder COVID-19 disease course. A range of dermatoses have also been reported with COVID-19 vaccination but have rarely prevented subsequent vaccination. Summary Dermatologists should be aware of the associations between COVID-19 disease severity and cutaneous eruptions. Livedo racemosa and retiform purpura are particularly associated with increased disease severity and death. In the setting of COVID-19 vaccination, cutaneous eruptions can largely be managed symptomatically and very rarely do these reactions prevent subsequent vaccination.
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Affiliation(s)
- Sonia Himed
- College of Medicine, University of Cincinnati, Cincinnati, OH USA
| | - Ashley Gray
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH USA
| | - Zaynah Awethe
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH USA
| | - Karissa Libson
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH USA
| | - Benjamin H. Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH USA
| | - Abraham M. Korman
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH USA
| | - John C. L. Trinidad
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114 USA
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16
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Cazzato G, Cascardi E, Colagrande A, Foti C, Stellacci A, Marrone M, Ingravallo G, Arezzo F, Loizzi V, Solimando AG, Parente P, Maiorano E, Cormio G, Vacca A, Resta L. SARS-CoV-2 and Skin: New Insights and Perspectives. Biomolecules 2022; 12:biom12091212. [PMID: 36139051 PMCID: PMC9496354 DOI: 10.3390/biom12091212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/22/2022] [Accepted: 08/29/2022] [Indexed: 12/15/2022] Open
Abstract
The SARS-CoV-2 pandemic has disrupted global health systems and brought the entire globe to its knees. Although born as a disease of the respiratory system, COVID-19 can affect different parts of the body, including the skin. Reports of ongoing skin manifestations of COVID-19 have gradually multiplied, pushing researchers to investigate the etiopathogenic mechanisms underlying these phenomena in more depth. In an attempt to investigate the possible association between SARS-CoV-2, ACE2, TMPRSS2 and skin manifestations, we performed immunohistochemical investigations of the ACE2 receptor and TMPRSS2 in nine skin samples from SARS-CoV-2-positive patients compared to a cohort of healthy controls. Furthermore, after consulting public databases regarding ACE2 mRNA expression in various cell populations resident in the skin, we conducted a literature review aimed at outlining the current state of this topic. We did not find statistically different immuno-expression of ACE2 and TMPRSS2 between the group of SARS-CoV-2-positive patients (nine skin biopsies) and the control group. Regarding ACE2, major immunolabeling was present in the epidermal keratinocytes and, rarely, in the fibroblasts and in the adenomeres of the eccrine sweat glands. Regarding the immune expression of TMPRSS2, we found no significant differences between the two groups, with a weak immune staining only in some skin cytotypes. From the review of the literature, we isolated 35 relevant articles according to the inclusion criteria adopted. ACE2 appears to be a target of SARS-CoV-2, although, other receptor molecules may potentially be implicated, such as TMPRSS2. Future studies with large cases and different molecular investigative methods are needed to further elucidate the mechanisms underlying the skin manifestations of SARS-CoV-2.
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Affiliation(s)
- Gerardo Cazzato
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
- Correspondence: ; Tel.: +39-34-0520-3641
| | - Eliano Cascardi
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
- Pathology Unit, FPO-IRCCS Candiolo Cancer Institute, Str. Provinciale 142 lm 3.95, 10060 Candiolo, Italy
| | - Anna Colagrande
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Caterina Foti
- Section of Dermatology, Department of Biomedical Sciences and Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Alessandra Stellacci
- Section of Legal Medicine, Department of Interdisciplinary Medicine, Bari Policlinico Hospital, University of Bari, 70124 Bari, Italy
| | - Maricla Marrone
- Section of Legal Medicine, Department of Interdisciplinary Medicine, Bari Policlinico Hospital, University of Bari, 70124 Bari, Italy
| | - Giuseppe Ingravallo
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Francesca Arezzo
- Section of Gynecology and Obstetrics, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Vera Loizzi
- Section of Gynecology and Obstetrics, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Antonio Giovanni Solimando
- Section of Internal Medicine, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Paola Parente
- Pathology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, 71100 San Giovanni Rotondo, Italy
| | - Eugenio Maiorano
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Gennaro Cormio
- Oncology Unit IRCCS Istituto Tumori Giovanni Paolo II and Department of Interdisciplinary Medicine (DIM), University of Bari, 70124 Bari, Italy
| | - Angelo Vacca
- Section of Internal Medicine, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Leonardo Resta
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
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17
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Sun C, Han Y, Zhang R, Liu S, Wang J, Zhang Y, Chen X, Jiang C, Wang J, Fan X, Wang J. Regulated necrosis in COVID-19: A double-edged sword. Front Immunol 2022; 13:917141. [PMID: 36090995 PMCID: PMC9452688 DOI: 10.3389/fimmu.2022.917141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 08/01/2022] [Indexed: 11/18/2022] Open
Abstract
COVID-19 caused by SARS-CoV-2 can cause various systemic diseases such as acute pneumonia with cytokine storm. Constituted of necroptosis, pyroptosis, and ferroptosis, regulated necrosis constitutes the cell death patterns under the low apoptosis condition commonly observed in COVID-19. Regulated necrosis is involved in the release of cytokines like TNF-α, IL-1 β, and IL-6 and cell contents such as alarmins, PAMPs, and DAMPs, leading to more severe inflammation. Uncontrolled regulated necrosis may explain the poor prognosis and cytokine storm observed in COVID-19. In this review, the pathophysiology and mechanism of regulated necrosis with the double-edged sword effect in COVID-19 are thoroughly discussed in detail. Furthermore, this review also focuses on the biomarkers and potential therapeutic targets of the regulated necrosis pathway in COVID-19, providing practical guidance to judge the severity, prognosis, and clinical treatment of COVID-19 and guiding the development of clinical anti-SARS-CoV-2 drugs.
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Affiliation(s)
- Chen Sun
- Department of Pain Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yunze Han
- Department of Pain Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruoyu Zhang
- Department of Pain Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Simon Liu
- Medical Genomics Unit, National Human Genome Research Institute, Bethesda, MD, United States
| | - Jing Wang
- Department of Pain Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuqing Zhang
- Department of Pain Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xuemei Chen
- Department of Human Anatomy, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Chao Jiang
- Department of Neurology, Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junmin Wang
- Department of Human Anatomy, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
- *Correspondence: Jian Wang, ; Junmin Wang, ; Xiaochong Fan,
| | - Xiaochong Fan
- Department of Pain Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Jian Wang, ; Junmin Wang, ; Xiaochong Fan,
| | - Jian Wang
- Department of Pain Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Human Anatomy, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
- *Correspondence: Jian Wang, ; Junmin Wang, ; Xiaochong Fan,
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18
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Acute Generalized Exanthematous Pustulosis following SARS-CoV-2 Virus: Remdesivir as a Suspected Culprit. Case Rep Med 2022; 2022:9880827. [PMID: 35991338 PMCID: PMC9385380 DOI: 10.1155/2022/9880827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 07/23/2022] [Accepted: 07/30/2022] [Indexed: 11/28/2022] Open
Abstract
Acute generalized exanthematous pustulosis (AGEP) is an exanthematous condition, predominantly occurring as a result of drug reactions. We, hereby, present the first case of AGEP following treatment with remdesivir in a patient with COVID-19, without hydroxychloroquine use, which serves as a reminder to consider remdesivir as a possible causative agent when dealing with AGEP presentation in COVID patients.
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19
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Wang X, Xu X, Wu P, Wu M, Gan L, Jin J, Wu R, Liu W, Zhang K, Li D, Zheng X. Complanatuside alleviates inflammatory cell damage induced by pro-inflammatory cytokines in skin keratinocytes. Front Chem 2022; 10:909651. [PMID: 36034662 PMCID: PMC9399639 DOI: 10.3389/fchem.2022.909651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/27/2022] [Indexed: 12/03/2022] Open
Abstract
Cytokine-mediated inflammatory response is considered a cause of skin lesion in COVID-19 patients. Complanatuside is a flavonol glycoside isolated from Astragalus complanatus. Flavonoids from Astragalus complanatus were reported to have anti-inflammatory and anticancer activities but the potential protective effect of complanatuside on cytokine-induced inflammatory damage in skin keratinocytes is not known. The aim of this study is to explore the inhibitory effect of complanatuside on inflammation and its underlying mechanisms in skin epithelial HaCaT cells treated with inflammatory cytokines. The combination of IFN-γ, TNF-α, and IL-6 decreased cell viability, increased cell death, and pyroptosis in HaCaT cells. Treatment with complanatuside alleviated the effects of the cytokine combination on HaCaT cells. Complanatuside down-regulated pyroptosis related to NLRP3, GSDMD, and ASC. The effects of complanatuside were related to vast reductions in the levels of iNOS, COX-2, and ROS. Results of the present study indicate that complanatuside inhibited inflammation and protected the cells from inflammatory cell damage in HaCaT cells treated with the combination of IFN-γ, TNF-α, and IL-6. Complanatuside may be a promising candidate for inhibiting COVID-19 related skin inflammatory damage.
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Affiliation(s)
- Xiao Wang
- School of Biotechnology and Health Sciences, Wuyi University, Jiangmen City, China
| | - Xuetao Xu
- School of Biotechnology and Health Sciences, Wuyi University, Jiangmen City, China
- International Healthcare Innovation Institute (Jiangmen), Jiangmen, China
| | - Panpan Wu
- School of Biotechnology and Health Sciences, Wuyi University, Jiangmen City, China
- International Healthcare Innovation Institute (Jiangmen), Jiangmen, China
| | - Mengshuo Wu
- School of Biotechnology and Health Sciences, Wuyi University, Jiangmen City, China
| | - Lishe Gan
- School of Biotechnology and Health Sciences, Wuyi University, Jiangmen City, China
- International Healthcare Innovation Institute (Jiangmen), Jiangmen, China
| | - Jingwei Jin
- School of Biotechnology and Health Sciences, Wuyi University, Jiangmen City, China
| | - Rihui Wu
- School of Biotechnology and Health Sciences, Wuyi University, Jiangmen City, China
| | - Wenfeng Liu
- School of Biotechnology and Health Sciences, Wuyi University, Jiangmen City, China
| | - Kun Zhang
- School of Biotechnology and Health Sciences, Wuyi University, Jiangmen City, China
| | - Dongli Li
- International Healthcare Innovation Institute (Jiangmen), Jiangmen, China
- *Correspondence: Dongli Li, ; Xi Zheng,
| | - Xi Zheng
- Department of Chemical Biology, Ernest Mario School of Pharmacy, Rutgers, the State University of New Jersey, Piscataway, NJ, United States
- *Correspondence: Dongli Li, ; Xi Zheng,
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20
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Mahdiabadi S, Rajabi F, Tavakolpour S, Rezaei N. Immunological aspects of COVID-19 related skin manifestations: revisiting pathogenic mechanism in the light of new evidence. Dermatol Ther 2022; 35:e15758. [PMID: 35945107 PMCID: PMC9537898 DOI: 10.1111/dth.15758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 08/01/2022] [Indexed: 11/29/2022]
Abstract
The newly emerged coronavirus disease 2019 (COVID‐19), induced by a novel strain of the coronavirus family, named severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), is a rapidly spreading global threat. This virus affects a fair number of tissues in the human body by availing itself of potential target receptors like Angiotensin‐Converting Enzyme 2 (ACE2). Presenting with diverse clinical manifestations, COVID‐19 has raised the urge for extensive research in different medical fields, including dermatology. Developing a comprehensive knowledge of cutaneous manifestations is highly important as it can help us in early diagnosis and better management of the ongoing pandemic. The dermatological presentations of COVID‐19 are classified into main categories of vascular and non‐vascular (exanthematous) patterns. Though not yet fully confirmed, the pathogenesis of these cutaneous presentations has been suggested to be more related to the overactivation of the immune system. In this review, we discuss in detail the clinical features of the diverse skin lesions in COVID‐19 patients and the imperative role of the immune system in their pathogenesis and development. Furthermore, we will discuss the reasons behind the accentuation of skin lesions in COVID‐19 compared to the same virus family predecessors.
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Affiliation(s)
- Sara Mahdiabadi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.,Network of Dermatology Research (NDR), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Fateme Rajabi
- Network of Dermatology Research (NDR), Universal Scientific Education and Research Network (USERN), Tehran, Iran.,Center for Research & Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Tavakolpour
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Nima Rezaei
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.,Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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21
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Labella M, Céspedes JA, Doña I, Shamji MH, Agache I, Mayorga C, Torres MJ. The value of the basophil activation test in the evaluation of patients reporting allergic reactions to the BNT162b2 mRNA COVID-19 vaccine. Allergy 2022; 77:2067-2079. [PMID: 34689351 PMCID: PMC8653141 DOI: 10.1111/all.15148] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND mRNA-based COVID-19 vaccines have been reported to induce hypersensitivity reactions (HSR) in a small number of individuals. We aimed to evaluate the real-world incidence of the BNT162b2 mRNA COVID-19 vaccine HSR and to determine the value of the basophil activation test (BAT) in the allergological workup of patients reporting these reactions. METHODS We prospectively enrolled patients with a clinical history indicative of HSR to the BNT162b2 mRNA COVID-19 vaccine. The allergological workup included skin testing (STs) and BAT with polyethylene glycol (PEG) and the vaccine. In those with negative allergy assessments, the administration of the second dose of the BNT162b2 mRNA COVID-19 vaccine was offered. RESULTS Seventeen adults were included. Eleven cases (64.7%) tested negative in the allergological workup and tolerated the re-administration of the second dose of the vaccine and considered non-allergic. Six cases (35.3%) were considered allergic and classified into three groups: 2 subjects displayed positive STs and/or BAT to PEG (Group A), two individuals displayed positive BAT to the vaccine (Group B), and in 2 patients with moderate or severe reactions, the culprit was not identified, tested negative to STs and BAT to both PEG and vaccine (Group C). We further evaluated the value of BAT when the results were positive to the vaccine and negative to PEG by performing BAT in controls groups, finding positive BAT results in 50% of controls, all of them recovered from COVID-19 infection. In contrast, BAT was negative in patients who had not suffered from COVID-19 disease. CONCLUSIONS BAT can be used as a potential diagnostic tool for confirming allergy to PEG excipient but not to the vaccine as a positive result in BAT may indicate a past COVID-19 infection instead of an allergy.
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Affiliation(s)
- Marina Labella
- Allergy Research GroupInstituto de Investigación Biomédica de Málaga‐IBIMAMálagaSpain,Allergy UnitHospital Regional Universitario de MálagaMálagaSpain
| | - Jose Antonio Céspedes
- Allergy Research GroupInstituto de Investigación Biomédica de Málaga‐IBIMAMálagaSpain
| | - Inmaculada Doña
- Allergy Research GroupInstituto de Investigación Biomédica de Málaga‐IBIMAMálagaSpain,Allergy UnitHospital Regional Universitario de MálagaMálagaSpain
| | - Mohamed H. Shamji
- National Heart and Lung InstituteImperial College LondonLondonUK,NIHR Imperial Biomedical Research CentreLondonUK
| | - Ioana Agache
- Faculty of MedicineTransylvania UniversityBrasovRomania
| | - Cristobalina Mayorga
- Allergy Research GroupInstituto de Investigación Biomédica de Málaga‐IBIMAMálagaSpain
| | - Maria José Torres
- Allergy Research GroupInstituto de Investigación Biomédica de Málaga‐IBIMAMálagaSpain,Allergy UnitHospital Regional Universitario de MálagaMálagaSpain,Departamento de MedicinaUniversidad de MálagaMalagaSpain
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22
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de Seabra Rodrigues Dias IR, Cao Z, Kwok HF. Adamalysins in COVID-19 - Potential mechanisms behind exacerbating the disease. Biomed Pharmacother 2022; 150:112970. [PMID: 35658218 PMCID: PMC9010236 DOI: 10.1016/j.biopha.2022.112970] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/31/2022] [Accepted: 04/12/2022] [Indexed: 01/12/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19), caused by the SARS-CoV-2 virus, is a current pandemic that has resulted in nearly 250 million cases and over 5 million deaths. While vaccines have been developed to prevent infection, and most COVID-19 cases end up being fairly light, there are severe cases of COVID-19 that may end up in death, even with adequate healthcare treatment. New options to combat this disease's effects, therefore, could prove to be invaluable in saving lives. Adamalysins are proteins that have several roles in regulating different functions in the human body but are also known to have functions in inflammation. They are also known to have roles in several different diseases, including COVID-19, where ADAM17, in particular, is now well-known to have a prominent role, but also several diseases which include comorbidities that may worsen cases of COVID-19. Therefore, investigating the functions of adamalysins in disease may give us clues to the molecular workings of COVID-19 as well as potentially new therapeutic targets. Understanding these molecular mechanisms may also allow for an understanding of the mechanisms behind the rare severe side effects that occur in response to current COVID-19 vaccines, which may lead to better monitoring measures for people who may be more at risk of developing these side effects. This review investigates the known roles and functions of adamalysins in disease, including what is currently known of their involvement in COVID-19, and how these functions might be involved.
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Affiliation(s)
- Ivo Ricardo de Seabra Rodrigues Dias
- Department of Biomedical Sciences, Faculty of Health Sciences, University of Macau, Avenida de Universidade, Taipa, Macau SAR,Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Avenida de Universidade, Taipa, Macau SAR
| | - Zhijian Cao
- State Key Laboratory of Virology and Modern Virology Research Center, College of Life Sciences, Wuhan University, Wuhan 430072, Hubei, China,Co-corresponding author
| | - Hang Fai Kwok
- Department of Biomedical Sciences, Faculty of Health Sciences, University of Macau, Avenida de Universidade, Taipa, Macau SAR,Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Avenida de Universidade, Taipa, Macau SAR,Corresponding author at: Department of Biomedical Sciences, Faculty of Health Sciences, University of Macau, Avenida de Universidade, Taipa, Macau SAR
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23
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Santos S, Barata P, Charmier A, Lehmann I, Rodrigues S, Melosini MM, Pais PJ, Sousa AP, Teixeira C, Santos I, Rocha AC, Baylina P, Fernandes R. Cannabidiol and Terpene Formulation Reducing SARS-CoV-2 Infectivity Tackling a Therapeutic Strategy. Front Immunol 2022; 13:841459. [PMID: 35242142 PMCID: PMC8886108 DOI: 10.3389/fimmu.2022.841459] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/21/2022] [Indexed: 11/13/2022] Open
Abstract
In late 2019, COVID-19 emerged in Wuhan, China. Currently, it is an ongoing global health threat stressing the need for therapeutic compounds. Linking the virus life cycle and its interaction with cell receptors and internal cellular machinery is key to developing therapies based on the control of infectivity and inflammation. In this framework, we evaluate the combination of cannabidiol (CBD), as an anti-inflammatory molecule, and terpenes, by their anti-microbiological properties, in reducing SARS-CoV-2 infectivity. Our group settled six formulations combining CBD and terpenes purified from Cannabis sativa L, Origanum vulgare, and Thymus mastichina. The formulations were analyzed by HPLC and GC-MS and evaluated for virucide and antiviral potential by in vitro studies in alveolar basal epithelial, colon, kidney, and keratinocyte human cell lines. Conclusions and Impact We demonstrate the virucide effectiveness of CBD and terpene-based formulations. F2TC reduces the infectivity by 17%, 24%, and 99% for CaCo-2, HaCat, and A549, respectively, and F1TC by 43%, 37%, and 29% for Hek293T, HaCaT, and Caco-2, respectively. To the best of our knowledge, this is the first approach that tackles the combination of CBD with a specific group of terpenes against SARS-CoV-2 in different cell lines. The differential effectiveness of formulations according to the cell line can be relevant to understanding the pattern of virus infectivity and the host inflammation response, and lead to new therapeutic strategies.
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Affiliation(s)
- Susana Santos
- R&D&Innovation Department, EXMceuticals Portugal Lda, Lisboa, Portugal.,Cooperativa de Formação e Animação Cultural - Centre for Interdisciplinary Development and Research on Environment, Applied Management and Space (COFAC-DREAMS)-Universidade Lusófona, Lisboa, Portugal
| | - Pedro Barata
- LABMI - Laboratório de Biotecnologia Médica e Industrial, PORTIC - Porto Research, Technology and Innovation Center, Porto, Portugal.,Metabesity Deopartment, i3S - Instituto de Investigação e Inovação em Saúde, Porto, Portugal
| | - Adilia Charmier
- R&D&Innovation Department, EXMceuticals Portugal Lda, Lisboa, Portugal.,Cooperativa de Formação e Animação Cultural - Centre for Interdisciplinary Development and Research on Environment, Applied Management and Space (COFAC-DREAMS)-Universidade Lusófona, Lisboa, Portugal
| | - Inês Lehmann
- R&D&Innovation Department, EXMceuticals Portugal Lda, Lisboa, Portugal
| | | | - Matteo M Melosini
- R&D&Innovation Department, EXMceuticals Portugal Lda, Lisboa, Portugal
| | - Patrick J Pais
- LABMI - Laboratório de Biotecnologia Médica e Industrial, PORTIC - Porto Research, Technology and Innovation Center, Porto, Portugal.,Metabesity Deopartment, i3S - Instituto de Investigação e Inovação em Saúde, Porto, Portugal
| | - André P Sousa
- LABMI - Laboratório de Biotecnologia Médica e Industrial, PORTIC - Porto Research, Technology and Innovation Center, Porto, Portugal.,Metabesity Deopartment, i3S - Instituto de Investigação e Inovação em Saúde, Porto, Portugal.,Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal
| | - Catarina Teixeira
- LABMI - Laboratório de Biotecnologia Médica e Industrial, PORTIC - Porto Research, Technology and Innovation Center, Porto, Portugal.,Metabesity Deopartment, i3S - Instituto de Investigação e Inovação em Saúde, Porto, Portugal.,Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal
| | - Inês Santos
- LABMI - Laboratório de Biotecnologia Médica e Industrial, PORTIC - Porto Research, Technology and Innovation Center, Porto, Portugal.,Metabesity Deopartment, i3S - Instituto de Investigação e Inovação em Saúde, Porto, Portugal.,Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal
| | - Ana Catarina Rocha
- LABMI - Laboratório de Biotecnologia Médica e Industrial, PORTIC - Porto Research, Technology and Innovation Center, Porto, Portugal.,Metabesity Deopartment, i3S - Instituto de Investigação e Inovação em Saúde, Porto, Portugal
| | - Pilar Baylina
- LABMI - Laboratório de Biotecnologia Médica e Industrial, PORTIC - Porto Research, Technology and Innovation Center, Porto, Portugal.,Metabesity Deopartment, i3S - Instituto de Investigação e Inovação em Saúde, Porto, Portugal.,Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal
| | - Ruben Fernandes
- LABMI - Laboratório de Biotecnologia Médica e Industrial, PORTIC - Porto Research, Technology and Innovation Center, Porto, Portugal.,Metabesity Deopartment, i3S - Instituto de Investigação e Inovação em Saúde, Porto, Portugal.,Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal
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24
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Qaderi K, Golezar MH, Mardani A, Mallah MA, Moradi B, Kavoussi H, Shamsabadi A, Golezar S. Cutaneous adverse reactions of COVID-19 vaccines: a systematic review. Dermatol Ther 2022; 35:e15391. [PMID: 35194894 PMCID: PMC9111405 DOI: 10.1111/dth.15391] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Numerous vaccines are under clinical development and implementation for the prevention of severe course and lethal outcomes of coronavirus disease 2019 (COVID-19). This systematic review aims to summarize and integrated the findings of studies regarding cutaneous side effects of COVID-19 vaccines. METHODS This systematic review conducted by searching the scientific databases of PubMed, Scopus, Science direct, and Web of knowledge from the beginning of the COVID-19 to10/5/2021. Articles were reviewed and analyzed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. RESULTS 17 studies on cutaneous side effects of COVID-19 vaccines were included after the screening of search results based on to the eligibility criteria. The results showed that the most common injection site reactions and delayed large local reactions, arising from all vaccine types, were redness/ erythema (39%), followed by: itchiness (28%), urticarial rash (17%) on the neck, upper limbs, and trunk, morbilliform eruptions (6.5%), Pityriasis rosea (3%), swelling, and burning, etc. Most cutaneous reactions occurred in women (84%), and middle aged people, after the first dose of vaccine, with the onset ranged from 1-21 days after vaccination. In addition, cutaneous reactions were generally self-limiting, and needed little or no therapeutic intervention, that were not regarded as a barrier to injecting a second dose. CONCLUSION In conclusion, severe cutaneous side effects are very rare and approved vaccines have satisfactory safety profiles. Therefore, mild or moderate cutaneous reactions should not discourage people from vaccination. In certain groups such as patients with allergies and a history of local injection reactions, pre-vaccination counseling and assurance, also use of appropriate medications may be helpful. However, more studies are needed to investigate the side effect profile of all COVID-19 vaccines.
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Affiliation(s)
- Kowsar Qaderi
- Midwifery and Reproductive Health Department, Nursing and Midwifery school, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | | | - Abbas Mardani
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Manthar Ali Mallah
- College of Public Health, Zhengzhou University, 100 Kexue Ave, Zhongyuan District, Zhengzhou, China
| | - Bagher Moradi
- Department of health information technology, Esfarayen Faculty of Medical Science, Esfarayen, Iran
| | - Hossein Kavoussi
- Dermatology Department, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Ahmadreza Shamsabadi
- Department of health information technology, Esfarayen Faculty of Medical Science, Esfarayen, Iran
| | - Samira Golezar
- Midwifery and Reproductive Health Department, Nursing and Midwifery school, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
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25
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Mitamura Y, Schulz D, Oro S, Li N, Kolm I, Lang C, Ziadlou R, Tan G, Bodenmiller B, Steiger P, Marzano A, Prost N, Caudin O, Levesque M, Stoffel C, Schmid‐Grendelmeier P, Maverakis E, Akdis CA, Brüggen M. Cutaneous and systemic hyperinflammation drives maculopapular drug exanthema in severely ill COVID-19 patients. Allergy 2022; 77:595-608. [PMID: 34157151 PMCID: PMC8441838 DOI: 10.1111/all.14983] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/03/2021] [Accepted: 06/10/2021] [Indexed: 02/07/2023]
Abstract
Background Coronavirus disease‐2019 (COVID‐19) has been associated with cutaneous findings, some being the result of drug hypersensitivity reactions such as maculopapular drug rashes (MDR). The aim of this study was to investigate whether COVID‐19 may impact the development of the MDR. Methods Blood and skin samples from COVID‐19 patients (based on a positive nasopharyngeal PCR) suffering from MDR (COVID‐MDR), healthy controls, non‐COVID‐19—related patients with drug rash with eosinophilia and systemic symptoms (DRESS), and MDR were analyzed. We utilized imaging mass cytometry (IMC) to characterize the cellular infiltrate in skin biopsies. Furthermore, RNA sequencing transcriptome of skin biopsy samples and high‐throughput multiplexed proteomic profiling of serum were performed. Results IMC revealed by clustering analyses a more prominent, phenotypically shifted cytotoxic CD8+ T cell population and highly activated monocyte/macrophage (Mo/Mac) clusters in COVID‐MDR. The RNA sequencing transcriptome demonstrated a more robust cytotoxic response in COVID‐MDR skin. However, severe acute respiratory syndrome coronavirus 2 was not detected in skin biopsies at the time point of MDR diagnosis. Serum proteomic profiling of COVID‐MDR patients revealed upregulation of various inflammatory mediators (IL‐4, IL‐5, IL‐6, TNF, and IFN‐γ), eosinophil and Mo/Mac ‐attracting chemokines (MCP‐2, MCP‐3, MCP‐4 and CCL11). Proteomics analyses demonstrated a massive systemic cytokine storm in COVID‐MDR compared with the relatively milder cytokine storm observed in DRESS, while MDR did not exhibit such features. Conclusion A systemic cytokine storm may promote activation of Mo/Mac and cytotoxic CD8+ T cells in severe COVID‐19 patients, which in turn may impact the development of MDR.
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Affiliation(s)
| | - Daniel Schulz
- Institute for Molecular Health SciencesETH Zurich Zurich Switzerland
- Department of Quantitative Biomedicine University of Zurich Zurich Switzerland
| | - Saskia Oro
- Department of Dermatology Henri Mondor Hospital Paris France
| | - Nick Li
- Department of Dermatology University Hospital Zurich Zurich Switzerland
- Faculty of Medicine University Zurich Zurich Switzerland
| | - Isabel Kolm
- Department of Dermatology University Hospital Zurich Zurich Switzerland
- Faculty of Medicine University Zurich Zurich Switzerland
| | - Claudia Lang
- Department of Dermatology University Hospital Zurich Zurich Switzerland
- Faculty of Medicine University Zurich Zurich Switzerland
| | - Reihane Ziadlou
- Department of Dermatology University Hospital Zurich Zurich Switzerland
- Faculty of Medicine University Zurich Zurich Switzerland
| | - Ge Tan
- Swiss Institute for Allergy Research (SIAF) Davos Davos Switzerland
| | - Bernd Bodenmiller
- Institute for Molecular Health SciencesETH Zurich Zurich Switzerland
- Department of Quantitative Biomedicine University of Zurich Zurich Switzerland
| | - Peter Steiger
- Faculty of Medicine University Zurich Zurich Switzerland
- Department of Intensive Care Medicine University Hospital Zurich Zurich Switzerland
| | - Angelo Marzano
- Dermatology Unit Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan Italy
- Department of Pathophysiology and Transplantation Università degli Studi di Milano Milan Italy
| | - Nicolas Prost
- Department of Dermatology Henri Mondor Hospital Paris France
| | - Olivier Caudin
- Department of Dermatology Henri Mondor Hospital Paris France
| | - Mitchell Levesque
- Department of Dermatology University Hospital Zurich Zurich Switzerland
- Faculty of Medicine University Zurich Zurich Switzerland
| | - Corinne Stoffel
- Department of Dermatology University Hospital Zurich Zurich Switzerland
- Faculty of Medicine University Zurich Zurich Switzerland
| | - Peter Schmid‐Grendelmeier
- Department of Dermatology University Hospital Zurich Zurich Switzerland
- Faculty of Medicine University Zurich Zurich Switzerland
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
| | - Emanual Maverakis
- Department of Dermatology University of California, Davis Sacramento CA USA
| | - Cezmi A. Akdis
- Swiss Institute for Allergy Research (SIAF) Davos Davos Switzerland
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
| | - Marie‐Charlotte Brüggen
- Department of Dermatology University Hospital Zurich Zurich Switzerland
- Faculty of Medicine University Zurich Zurich Switzerland
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
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26
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Senet P. Quoi de neuf en dermatologie clinique ? ANNALES DE DERMATOLOGIE ET DE VÉNÉRÉOLOGIE - FMC 2021. [PMCID: PMC8675603 DOI: 10.1016/s2667-0623(21)01524-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- P. Senet
- Service de dermatologie, AP-HP, hôpital Tenon, Paris
- Adresse e-mail : (P. Senet)
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27
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Csekes E, Račková L. Skin Aging, Cellular Senescence and Natural Polyphenols. Int J Mol Sci 2021; 22:12641. [PMID: 34884444 PMCID: PMC8657738 DOI: 10.3390/ijms222312641] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/13/2021] [Accepted: 11/18/2021] [Indexed: 01/10/2023] Open
Abstract
The skin, being the barrier organ of the body, is constitutively exposed to various stimuli impacting its morphology and function. Senescent cells have been found to accumulate with age and may contribute to age-related skin changes and pathologies. Natural polyphenols exert many health benefits, including ameliorative effects on skin aging. By affecting molecular pathways of senescence, polyphenols are able to prevent or delay the senescence formation and, consequently, avoid or ameliorate aging and age-associated pathologies of the skin. This review aims to provide an overview of the current state of knowledge in skin aging and cellular senescence, and to summarize the recent in vitro studies related to the anti-senescent mechanisms of natural polyphenols carried out on keratinocytes, melanocytes and fibroblasts. Aged skin in the context of the COVID-19 pandemic will be also discussed.
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Affiliation(s)
- Erika Csekes
- Centre of Experimental Medicine, Institute of Experimental Pharmacology and Toxicology, Slovak Academy of Sciences, Dúbravská Cesta 9, 841 04 Bratislava, Slovakia
| | - Lucia Račková
- Centre of Experimental Medicine, Institute of Experimental Pharmacology and Toxicology, Slovak Academy of Sciences, Dúbravská Cesta 9, 841 04 Bratislava, Slovakia
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28
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Gao YD, Agache I, Akdis M, Nadeau K, Klimek L, Jutel M, Akdis CA. The effect of allergy and asthma as a comorbidity on the susceptibility and outcomes of COVID-19. Int Immunol 2021; 34:177-188. [PMID: 34788827 PMCID: PMC8689956 DOI: 10.1093/intimm/dxab107] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 11/10/2021] [Indexed: 12/12/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic causes an overwhelming number of hospitalization and deaths with a significant socioeconomic impact. The vast majority of studies indicate that asthma and allergic diseases do not represent a risk factor for COVID-19 susceptibility nor cause a more severe course of disease. This raises the opportunity to investigate the underlying mechanisms of the interaction between an allergic background and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The majority of patients with asthma, atopic dermatitis, allergic rhinitis, chronic rhinosinusitis, food allergies and drug allergies exhibit an over-expression of type 2 immune and inflammatory pathways with the contribution of epithelial cells, innate lymphoid cells, dendritic cells, T cells, eosinophils, mast cells, basophils, and the type 2 cytokines interleukin (IL)-4, IL-5, IL-9, IL-13, and IL-31. The potential impact of type 2 inflammation-related allergic diseases on susceptibility to COVID-19 and severity of its course have been reported. In this review, the prevalence of asthma and other common allergic diseases in COVID-19 patients is addressed. Moreover, the impact of allergic and non-allergic asthma with different severity and control status, currently available asthma treatments such as inhaled and oral corticosteroids, short- and long-acting β2 agonists, leukotriene receptor antagonists and biologicals on the outcome of COVID-19 patients is reviewed. In addition, possible protective mechanisms of asthma and type 2 inflammation on COVID-19 infection, such as the expression of SARS-CoV-2 entry receptors, antiviral activity of eosinophils and cross-reactive T-cell epitopes, are discussed. Potential interactions of other allergic diseases with COVID-19 are postulated, including recommendations for their management.
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Affiliation(s)
- Ya-Dong Gao
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.,Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, Hubei, China
| | - Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Herman-Burchard Strasse, Davos, Switzerland
| | - Kari Nadeau
- Sean N. Parker Center for Allergy and Asthma Research, Department of Medicine, Stanford University, Palo Alto, California, USA
| | - Ludger Klimek
- Center for Rhinology and Allergology, An den Quellen, Wiesbaden, Germany
| | - Marek Jutel
- Department of Clinical Immunology, Wrocław Medical University.,All-MED Medical Research Institute, Wrocław, Poland
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Herman-Burchard Strasse, Davos, Switzerland
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29
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Magro C, Nuovo G, Mulvey JJ, Laurence J, Harp J, Crowson AN. The skin as a critical window in unveiling the pathophysiologic principles of COVID-19. Clin Dermatol 2021; 39:934-965. [PMID: 34920833 PMCID: PMC8298003 DOI: 10.1016/j.clindermatol.2021.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiologic agent of coronavirus disease 2019 (COVID-19), is a single-stranded RNA virus whose sequence is known. COVID-19 is associated with a heterogeneous clinical phenotype ranging from asymptomatic to fatal disease. It appears that access to nasopharyngeal respiratory epithelia expressing angiotensin-converting enzyme (ACE) 2, the receptor for SARS-CoV-2, is followed by viral replication in the pulmonary alveolar septal capillary bed. We have demonstrated in earlier studies that incomplete viral particles, termed pseudovirions, dock to deep subcutaneous and other vascular beds, potentially contributing to the prothrombotic state and systemic complement activation that characterizes severe and critical COVID-19. A variety of skin eruptions have been described in the setting of SARS-CoV-2 infection and more recently, after COVID-19 vaccination. The vaccines deliver a laboratory-synthesized mRNA that encodes a protein that is identical to the spike glycoprotein of SARS-CoV-2, allowing the production of immunogenic spike glycoprotein that will then elicit T cell and B cell adaptive immune responses. In this contribution, we review an array of cutaneous manifestations of COVID-19 that provide an opportunity to study critical pathophysiologic mechanisms that underlie all clinical facets of COVID-19, ranging from asymptomatic/mild to severe and critical COVID-19. We classify cutaneous COVID-19 according to underlying pathophysiologic principles. In this regard we propose three main pathways: (1) complement mediated thrombotic vascular injury syndromes deploying the alternative and mannan binding lectin pathways and resulting in the elaboration of cytokines like interleukin 6 from endothelium in the setting of severe and critical COVID-19 and (2) the robust T cell and type I interferon-driven inflammatory and (3) humoral-driven immune complex mediated vasculitic cutaneous reactions observed with mild and moderate COVID-19. Presented are novel data on cutaneous vaccine reactions that manifest a clinical and morphologic parallel with similar eruptions observed in patients with mild and moderate COVID-19 and in some cases represent systemic eczematoid hypersensitivity reactions to a putative vaccine-based antigen versus unmasking subclinical hypersensitivity due to immune enhancing effects of the vaccine. Finally, we demonstrate for the first time the localization of human synthesized spike glycoprotein after the COVID-19 vaccine to the cutaneous and subcutaneous vasculature confirming the ability of SARS-CoV-2 spike glycoprotein to bind endothelium in the absence of intact virus.
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30
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Gawaz A, Guenova E. Microvascular Skin Manifestations Caused by COVID-19. Hamostaseologie 2021; 41:387-396. [PMID: 34695855 DOI: 10.1055/a-1581-6899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Hypercoagulability and vascular injury, which characterize morbidity in COVID-19 disease, are frequently observed in the skin. Several pathomechanisms, such as inflammation caused by angiotensin-converting enzyme 2-mediated uptake into endothelial cells or SARS-CoV-2-initiated host immune responses, contribute to microthrombus formation and the appearance of vascular skin lesions. Besides pathophysiologic mechanisms observed in the skin, this review describes the clinical appearance of cutaneous vascular lesions and their association with COVID-19 disease, including acro-ischemia, reticular lesions, and cutaneous small vessel vasculitis. Clinicians need to be aware that skin manifestations may be the only symptom in SARS-CoV-2 infection, and that inflammatory and thrombotic SARS-CoV-2-driven processes observed in multiple organs and tissues appear identically in the skin as well.
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Affiliation(s)
- Andrea Gawaz
- Universitätshautklinik Tübingen, Tübingen, Germany
| | - Emmanuella Guenova
- Department of Dermatology, Lausanne University Hospital, Lausanne, Switzerland
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31
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Mohseni Afshar Z, Babazadeh A, Hasanpour A, Barary M, Sayad B, Janbakhsh A, Aryanian Z, Ebrahimpour S. Dermatological manifestations associated with COVID-19: A comprehensive review of the current knowledge. J Med Virol 2021; 93:5756-5767. [PMID: 34241899 PMCID: PMC8427109 DOI: 10.1002/jmv.27187] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023]
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has become a significant health problem globally. The virus has spread widely and become a global pandemic. The pathophysiology for SARS-CoV-2 has not been explained clearly. It has been associated with several multiorgan symptoms, among which its dermatological manifestations are of great interest. Primarily, there has been no report of skin features among COVID-19 patients. Nevertheless, recently there have been several reports regarding COVID-19 patients who presented with cutaneous manifestations. In the current review, we focus on the various cutaneous manifestations of COVID-19 infection.
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Affiliation(s)
- Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research Center, Health Research InstituteBabol University of Medical SciencesBabolIran
| | | | - Mohammad Barary
- Student Research CommitteeBabol University of Medical SciencesBabolIran
| | - Babak Sayad
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Alireza Janbakhsh
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Zeinab Aryanian
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran
- Department of Dermatology, School of MedicineBabol University of Medical SciencesBabolIran
| | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research Center, Health Research InstituteBabol University of Medical SciencesBabolIran
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32
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33
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Ding M, Dong X, Sun YL, Sokolowska M, Akdis M, van de Veen W, Azkur AK, Azkur D, Akdis CA, Gao YD. Recent advances and developments in COVID-19 in the context of allergic diseases. Clin Transl Allergy 2021; 11:e12065. [PMID: 34582102 PMCID: PMC8646609 DOI: 10.1002/clt2.12065] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Since the first reports of coronavirus disease 2019 (COVID-19) in Wuhan, China, in December 2019, there have been 198 million confirmed cases worldwide as of August 2021. The scientific community has joined efforts to gain knowledge of the newly emerged virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the immunopathological mechanisms leading to COVID-19, and its significance for patients with allergies and asthma. METHODS Based on the current literature, recent advances and developments in COVID-19 in the context of allergic diseases were reviewed. RESULTS AND CONCLUSIONS In this review, we discuss the prevalence of COVID-19 in subjects with asthma, attacks of hereditary angioedema, and other allergic diseases during COVID-19. Underlying mechanisms suggest a protective role of allergy in COVID-19, involving eosinophilia, SARS-CoV-2 receptors expression, interferon responses, and other immunological events, but further studies are needed to fully understand those associations. There has been significant progress in disease evaluation and management of COVID-19, and allergy care should continue during the COVID-19 pandemic. The European Academy of Allergy & Clinical Immunology (EAACI) launched a series of statements and position papers providing recommendations on the organization of the allergy clinic, handling of allergen immunotherapy, asthma, drug hypersensitivity, allergic rhinitis, and other allergic diseases. Treatment of allergies using biologics during the COVID-19 pandemic has also been discussed. Allergic reactions to the COVID-19 vaccines, including severe anaphylaxis, have been reported. Vaccination is a prophylactic strategy that can lead to a significant reduction in the mortality and morbidity associated with SARS-CoV-2 infection, and in this review, we discuss the proposed culprit components causing rare adverse reactions and recommendations to mitigate the risk of anaphylactic events during the administration of the vaccines.
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Affiliation(s)
- Mei Ding
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, China
| | - Xiang Dong
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, China
| | - Yuan-Li Sun
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, China
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.,Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Willem van de Veen
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Ahmet Kursat Azkur
- Department of Virology, Faculty of Veterinary Medicine, University of Kirikkale, Kirikkale, Turkey
| | - Dilek Azkur
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, University of Kirikkale, Kirikkale, Turkey
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.,Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Ya-Dong Gao
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, China
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34
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[SARS-CoV-2-update on skin manifestations, predictive markers and cutaneous reactions after vaccination]. Hautarzt 2021; 72:929-932. [PMID: 34480208 PMCID: PMC8415434 DOI: 10.1007/s00105-021-04881-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2021] [Indexed: 12/03/2022]
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35
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Niebel D, Novak N, Wilhelmi J, Ziob J, Wilsmann-Theis D, Bieber T, Wenzel J, Braegelmann C. Cutaneous Adverse Reactions to COVID-19 Vaccines: Insights from an Immuno-Dermatological Perspective. Vaccines (Basel) 2021; 9:944. [PMID: 34579181 PMCID: PMC8470727 DOI: 10.3390/vaccines9090944] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/20/2021] [Accepted: 08/24/2021] [Indexed: 02/07/2023] Open
Abstract
(1) Background: Numerous vaccines are under preclinical and clinical development for prevention of severe course and lethal outcome of coronavirus disease 2019 (COVID-19). In light of high efficacy rates and satisfactory safety profiles, some agents have already reached approval and are now distributed worldwide, with varying availability. Real-world data on cutaneous adverse drug reactions (ADRs) remain limited. (2) Methods: We performed a literature research concerning cutaneous ADRs to different COVID-19 vaccines, and incorporated our own experiences. (3) Results: Injection site reactions are the most frequent side effects arising from all vaccine types. Moreover, delayed cutaneous ADRs may occur after several days, either as a primary manifestation or as a flare of a pre-existing inflammatory dermatosis. Cutaneous ADRs may be divided according to their cytokine profile, based on the preponderance of specific T-cell subsets (i.e., Th1, Th2, Th17/22, Tregs). Specific cutaneous ADRs mimic immunogenic reactions to the natural infection with SARS-CoV-2, which is associated with an abundance of type I interferons. (4) Conclusions: Further studies are required in order to determine the best suitable vaccine type for individual groups of patients, including patients suffering from chronic inflammatory dermatoses.
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Affiliation(s)
- Dennis Niebel
- Department of Dermatology and Allergy, University Hospital Bonn, 53127 Bonn, Germany; (N.N.); (J.W.); (J.Z.); (D.W.-T.); (T.B.); (J.W.); (C.B.)
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Cazzato G, Colagrande A, Cimmino A, Cicco G, Scarcella VS, Tarantino P, Lospalluti L, Romita P, Foti C, Demarco A, Sablone S, Candance PMV, Cicco S, Lettini T, Ingravallo G, Resta L. HMGB1-TIM3-HO1: A New Pathway of Inflammation in Skin of SARS-CoV-2 Patients? A Retrospective Pilot Study. Biomolecules 2021; 11:biom11081219. [PMID: 34439887 PMCID: PMC8392002 DOI: 10.3390/biom11081219] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/07/2021] [Accepted: 08/13/2021] [Indexed: 02/05/2023] Open
Abstract
The SARS-CoV-2 pandemic has completely disrupted the health systems of the entire planet. From the earliest months, it became increasingly clear that in addition to affecting the upper airways and lungs, there were other organs that could be affected. Among these, the skin became a real "sentinel signal" to be able to even suspect COVID-19. Background: this study deals with a little-explored issue for now: the study of skin immunopathology in SARS-CoV-2 positive subjects ascertained using the most reliable methods available. Methods: we used skin biopsy samples from SARS-CoV-2 positive and negative patients, studying morphology (Hematoxylin-Eosin), T lymphocyte population (CD4 and CD8), three markers such as HMGB-1, TIM-3 and HO-1 by immunohistochemistry. Results: although the presence of the CD4 and CD8 T population did not differ statistically significantly, we found greater activation and release of HMGB-1 in skin samples from SARS-CoV-2 positive patients, greater immunolabeling for TIM-3 at the level of CD4 and CD8 and a reduced expression of Heme oxygenase 1. Conclusions: these results support the possibility that there is immune deregulation in SARS-CoV-2 positive patients who develop skin manifestations of various kinds.
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Affiliation(s)
- Gerardo Cazzato
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (G.C.); (V.S.S.); (P.T.); (P.M.V.C.); (T.L.); (L.R.)
- Correspondence: (G.C.); (G.I.); Tel.: +39-340-520-3641 (G.C.); +39-338-853-6505 (G.I.)
| | - Anna Colagrande
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (G.C.); (V.S.S.); (P.T.); (P.M.V.C.); (T.L.); (L.R.)
| | - Antonietta Cimmino
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (G.C.); (V.S.S.); (P.T.); (P.M.V.C.); (T.L.); (L.R.)
| | - Gerolamo Cicco
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (G.C.); (V.S.S.); (P.T.); (P.M.V.C.); (T.L.); (L.R.)
| | - Vincenza Sara Scarcella
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (G.C.); (V.S.S.); (P.T.); (P.M.V.C.); (T.L.); (L.R.)
| | - Paola Tarantino
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (G.C.); (V.S.S.); (P.T.); (P.M.V.C.); (T.L.); (L.R.)
| | - Lucia Lospalluti
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (L.L.); (P.R.); (C.F.); (A.D.)
| | - Paolo Romita
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (L.L.); (P.R.); (C.F.); (A.D.)
| | - Caterina Foti
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (L.L.); (P.R.); (C.F.); (A.D.)
| | - Aurora Demarco
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (L.L.); (P.R.); (C.F.); (A.D.)
| | - Sara Sablone
- Section of Legal Medicine, Department of Interdisciplinary Medicine, Bari Policlinico Hospital, University of Bari, 70124 Bari, Italy;
| | - Pragnell Maria Victoria Candance
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (G.C.); (V.S.S.); (P.T.); (P.M.V.C.); (T.L.); (L.R.)
| | - Sebastiano Cicco
- Section of Internal Medicine “G. Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy;
| | - Teresa Lettini
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (G.C.); (V.S.S.); (P.T.); (P.M.V.C.); (T.L.); (L.R.)
| | - Giuseppe Ingravallo
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (G.C.); (V.S.S.); (P.T.); (P.M.V.C.); (T.L.); (L.R.)
- Correspondence: (G.C.); (G.I.); Tel.: +39-340-520-3641 (G.C.); +39-338-853-6505 (G.I.)
| | - Leonardo Resta
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (G.C.); (V.S.S.); (P.T.); (P.M.V.C.); (T.L.); (L.R.)
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Cutaneous Manifestations of COVID-19: A Brief Review of a Possible Diagnostic Tool. JOURNAL OF SKIN AND STEM CELL 2021. [DOI: 10.5812/jssc.110666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Novak N, Tordesillas L, Cabanillas B. Adverse rare events to vaccines for COVID-19: From hypersensitivity reactions to thrombosis and thrombocytopenia. Int Rev Immunol 2021; 41:438-447. [PMID: 34251972 PMCID: PMC8290371 DOI: 10.1080/08830185.2021.1939696] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/14/2021] [Accepted: 05/29/2021] [Indexed: 01/18/2023]
Abstract
Vaccines for the prevention of coronavirus disease 2019 (COVID-19) started to be developed since the initiation of the COVID-19 pandemic. Up to now, four vaccines have been authorized by international agencies such as European Medicines Agency (EMA). Two are DNA vaccines (ChAdOx1 nCov-19 and Ad26.COV2.S) and two mRNA vaccines (BNT162b2 and mRNA-1273). The administration of the vaccines has been associated with a strong decrease in the infections by SARS-CoV-2 and deaths associated with it. However, in parallel to these results, some rare adverse events have also been described. In that sense, events of thrombosis, thrombocytopenia, and hemorrhage have been described in close temporal proximity to the administration of the DNA vaccines ChAdOx1 nCov-19 and Ad26.COV2.S, but also mRNA vaccines. Recent scientific reports have been released with updated information on the possible association of thrombotic thrombocytopenia and COVID-19 vaccines. On the other hand, since the initiation of the vaccination campaigns, adverse hypersensitivity reactions have been described after mRNA and DNA vaccines administration for COVID-19. Although globally these adverse events are rare, a high proportion of the world population will be exposed to these vaccines. For that reason, their safety and tolerance should be carefully considered. In this review, we provide an updated review of the last scientific findings that can explain the rare side effects that the vaccines for COVID-19 can produce.
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Affiliation(s)
- Natalija Novak
- Department of Dermatology and Allergy, University Hospital, Bonn, Germany
| | - Leticia Tordesillas
- Department of Tumor Biology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Beatriz Cabanillas
- Department of Allergy, Research Institute Hospital 12 de Octubre, Madrid, Spain
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Trubiano JA, Soria A, Torres MJ, Trautmann A. Treating Through Drug-Associated Exanthems in Drug Allergy Management: Current Evidence and Clinical Aspects. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:2984-2993. [PMID: 33878455 DOI: 10.1016/j.jaip.2021.04.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/01/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
In the setting of an acute cutaneous adverse drug reaction there is increasing interest in selected phenotypes and hosts to continue drug therapy, especially in settings in which there are limited therapeutic options. This concept of "treating through," defined as the continued use of a drug in the setting of, in particular maculopapular exanthema, potentially avoids unnecessary drug discontinuation. A review of the recent literature, historical viewpoints, and expert opinion are provided within to form recommendations and algorithms for a "treating-through" approach.
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Affiliation(s)
- Jason A Trubiano
- Centre for Antibiotic Allergy and Research, Department of Infectious Diseases, Austin Health, Heidelberg, VIC, Australia; Department of Medicine (Austin Health), University of Melbourne, Heidelberg, VIC, Australia.
| | - Angèle Soria
- Sorbonne Universités, Paris, France; Service de Dermatologie et d'Allergologie, Hôpital Tenon, Paris HUEP, APHP, Paris, France; Centre d'Immunologie et des Maladies Infectieuses - Paris (Cimi-Paris), INSERM U1135, Paris, France
| | - Maria J Torres
- Allergy Unit, IBIMA-Regional University Hospital of Malaga UMA, Malaga, Spain; Andalusian Center for Nanomedicine and Biotechnology - BIONAND, Malaga, Spain
| | - Axel Trautmann
- Department of Dermatology and Allergy, University Hospital Würzburg, Würzburg, Germany
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40
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Brigger D, Horn MP, Pennington LF, Powell AE, Siegrist D, Weber B, Engler O, Piezzi V, Damonti L, Iseli P, Hauser C, Froehlich TK, Villiger PM, Bachmann MF, Leib SL, Bittel P, Fiedler M, Largiadèr CR, Marschall J, Stalder H, Kim PS, Jardetzky TS, Eggel A, Nagler M. Accuracy of serological testing for SARS-CoV-2 antibodies: First results of a large mixed-method evaluation study. Allergy 2021; 76:853-865. [PMID: 32997812 PMCID: PMC7537154 DOI: 10.1111/all.14608] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/11/2020] [Accepted: 09/13/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Serological immunoassays that can identify protective immunity against SARS-CoV-2 are needed to adapt quarantine measures, assess vaccination responses, and evaluate donor plasma. To date, however, the utility of such immunoassays remains unclear. In a mixed-design evaluation study, we compared the diagnostic accuracy of serological immunoassays that are based on various SARS-CoV-2 proteins and assessed the neutralizing activity of antibodies in patient sera. METHODS Consecutive patients admitted with confirmed SARS-CoV-2 infection were prospectively followed alongside medical staff and biobank samples from winter 2018/2019. An in-house enzyme-linked immunosorbent assay utilizing recombinant receptor-binding domain (RBD) of the SARS-CoV-2 spike protein was developed and compared to three commercially available enzyme-linked immunosorbent assays (ELISAs) targeting the nucleoprotein (N), the S1 domain of the spike protein (S1), and a lateral flow immunoassay (LFI) based on full-length spike protein. Neutralization assays with live SARS-CoV-2 were performed. RESULTS One thousand four hundred and seventy-seven individuals were included comprising 112 SARS-CoV-2 positives (defined as a positive real-time PCR result; prevalence 7.6%). IgG seroconversion occurred between day 0 and day 21. While the ELISAs showed sensitivities of 88.4% for RBD, 89.3% for S1, and 72.9% for N protein, the specificity was above 94% for all tests. Out of 54 SARS-CoV-2 positive individuals, 96.3% showed full neutralization of live SARS-CoV-2 at serum dilutions ≥ 1:16, while none of the 6 SARS-CoV-2-negative sera revealed neutralizing activity. CONCLUSIONS ELISAs targeting RBD and S1 protein of SARS-CoV-2 are promising immunoassays which shall be further evaluated in studies verifying diagnostic accuracy and protective immunity against SARS-CoV-2.
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Affiliation(s)
- Daniel Brigger
- Department of Rheumatology, Immunology, and AllergologyInselspital University HospitalBernSwitzerland
- Department of BioMedical ResearchUniversity of BernBernSwitzerland
| | - Michael P. Horn
- University Institute of Clinical ChemistryInselspital University HospitalBernSwitzerland
| | - Luke F. Pennington
- Department of Structural BiologyStanford University School of MedicineStanfordCAUSA
| | - Abigail E. Powell
- Standford Chem‐H and Department of BiochemistryStanford University School of MedicineStanfordCAUSA
- Chan Zuckerberg BiohubSan FranciscoCAUSA
| | - Denise Siegrist
- Spiez LaboratoryFederal Office for Civil ProtectionSpiezSwitzerland
| | - Benjamin Weber
- Spiez LaboratoryFederal Office for Civil ProtectionSpiezSwitzerland
| | - Olivier Engler
- Spiez LaboratoryFederal Office for Civil ProtectionSpiezSwitzerland
| | - Vanja Piezzi
- Department of Infectious DiseasesBern University HospitalUniversity of BernBernSwitzerland
| | - Lauro Damonti
- Department of Infectious DiseasesBern University HospitalUniversity of BernBernSwitzerland
| | - Patricia Iseli
- Occupational MedicineInselspital University HospitalBernSwitzerland
| | - Christoph Hauser
- Department of Infectious DiseasesBern University HospitalUniversity of BernBernSwitzerland
| | - Tanja K. Froehlich
- University Institute of Clinical ChemistryInselspital University HospitalBernSwitzerland
| | - Peter M. Villiger
- Department of Rheumatology, Immunology, and AllergologyInselspital University HospitalBernSwitzerland
| | - Martin F. Bachmann
- Department of Rheumatology, Immunology, and AllergologyInselspital University HospitalBernSwitzerland
- Department of BioMedical ResearchUniversity of BernBernSwitzerland
| | - Stephen L. Leib
- Institute for Infectious DiseasesUniversity of BernBernSwitzerland
| | - Pascal Bittel
- Institute for Infectious DiseasesUniversity of BernBernSwitzerland
| | - Martin Fiedler
- University Institute of Clinical ChemistryInselspital University HospitalBernSwitzerland
| | - Carlo R. Largiadèr
- University Institute of Clinical ChemistryInselspital University HospitalBernSwitzerland
| | - Jonas Marschall
- Department of Infectious DiseasesBern University HospitalUniversity of BernBernSwitzerland
| | - Hanspeter Stalder
- Vetsuisse FacultyInstitute of Virology and ImmunologyUniversity of BernBernSwitzerland
| | - Peter S. Kim
- Standford Chem‐H and Department of BiochemistryStanford University School of MedicineStanfordCAUSA
- Chan Zuckerberg BiohubSan FranciscoCAUSA
| | | | - Alexander Eggel
- Department of Rheumatology, Immunology, and AllergologyInselspital University HospitalBernSwitzerland
- Department of BioMedical ResearchUniversity of BernBernSwitzerland
| | - Michael Nagler
- University Institute of Clinical ChemistryInselspital University HospitalBernSwitzerland
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Giannitto C, Bonifacio C, Esposito S, Ammirabile A, Mercante G, De Virgilio A, Spriano G, Heffler E, Lofino L, Politi LS, Balzarini L. Sudden neck swelling with rash as late manifestation of COVID-19: a case report. BMC Infect Dis 2021; 21:232. [PMID: 33639889 PMCID: PMC7912866 DOI: 10.1186/s12879-021-05911-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 02/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although there are reports of otolaryngological symptoms and manifestations of CoronaVirus Disease 19 (COVID-19), there have been no documented cases of sudden neck swelling with rash in patients with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection described in literature. CASE PRESENTATION We report a case of a sudden neck swelling and rash likely due to late SARS-CoV-2 in a 64-year-old woman. The patient reported COVID-19 symptoms over the previous three weeks. Computed Tomography (CT) revealed a diffuse soft-tissue swelling and edema of subcutaneous tissue, hypodermis, and muscular and deep fascial planes. All the differential diagnoses were ruled out. Both the anamnestic history of the patient's husband who had died of COVID-19 with and the collateral findings of pneumonia and esophageal wall edema suggested the association with COVID-19. This was confirmed by nasopharyngeal swab polymerase chain reaction. The patient was treated with lopinavir/ritonavir, hydroxychloroquine and piperacillin/tazobactam for 7 days. The neck swelling resolved in less than 24 h, while the erythema was still present up to two days later. The patient was discharged after seven days in good clinical condition and with a negative swab. CONCLUSION Sudden neck swelling with rash may be a coincidental presentation, but, in the pandemic context, it is most likely a direct or indirect complication of COVID-19.
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Affiliation(s)
- Caterina Giannitto
- Department of Diagnostic Radiology, Humanitas Clinical and Research Center IRCCS, Via Alessandro Manzoni 56, 20089 Rozzano, Milan, Italy.
| | - Cristiana Bonifacio
- Department of Diagnostic Radiology, Humanitas Clinical and Research Center IRCCS, Via Alessandro Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Susanna Esposito
- Paediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University of Parma, 43121, Parma, Italy
| | - Angela Ammirabile
- Residency Program in Radiology, Humanitas University, Pieve Emanuele, 20072, Milan, Italy
| | - Giuseppe Mercante
- Otorhinolaryngology Unit, Humanitas University, Humanitas Clinical and Research Centre - IRCCS, Rozzano, 20089, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072, Milan, Italy
| | - Armando De Virgilio
- Otorhinolaryngology Unit, Humanitas University, Humanitas Clinical and Research Centre - IRCCS, Rozzano, 20089, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072, Milan, Italy
| | - Giuseppe Spriano
- Otorhinolaryngology Unit, Humanitas University, Humanitas Clinical and Research Centre - IRCCS, Rozzano, 20089, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072, Milan, Italy
| | - Enrico Heffler
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072, Milan, Italy
| | - Ludovica Lofino
- Residency Program in Radiology, Humanitas University, Pieve Emanuele, 20072, Milan, Italy
| | - Letterio Salvatore Politi
- Department of Diagnostic Radiology, Humanitas Clinical and Research Center IRCCS, Via Alessandro Manzoni 56, 20089 Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072, Milan, Italy
| | - Luca Balzarini
- Department of Diagnostic Radiology, Humanitas Clinical and Research Center IRCCS, Via Alessandro Manzoni 56, 20089 Rozzano, Milan, Italy
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Erkayman MH, Bilen H. Clearance of longstanding treatment-resistant warts during COVID-19 in a transplant recipient. Transpl Infect Dis 2021; 23:e13572. [PMID: 33507618 PMCID: PMC7994983 DOI: 10.1111/tid.13572] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/06/2021] [Accepted: 01/16/2021] [Indexed: 01/10/2023]
Abstract
Human papillomavirus (HPV), a DNA virus, infects basal keratinocytes and causes common warts and as well as malignancies of skin and mucous membranes. Although many treatment options are available, persistent HPV infections are common among transplant recipients. Herein, we present a patient with a 15‐year history of treatment‐resistant warts that regressed during COVID‐19 (Coronavirus disease 2019) treatment.
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Affiliation(s)
- Merve H Erkayman
- Department of Dermatology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Handan Bilen
- Department of Dermatology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
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Marzano AV, Genovese G, Moltrasio C, Gaspari V, Vezzoli P, Maione V, Misciali C, Sena P, Patrizi A, Offidani A, Quaglino P, Arco R, Caproni M, Rovesti M, Bordin G, Recalcati S, Potenza C, Guarneri C, Fabbrocini G, Tomasini C, Sorci M, Lombardo M, Gisondi P, Conti A, Casazza G, Peris K, Calzavara-Pinton P, Berti E. The clinical spectrum of COVID-19-associated cutaneous manifestations: An Italian multicenter study of 200 adult patients. J Am Acad Dermatol 2021; 84:1356-1363. [PMID: 33476725 PMCID: PMC7816892 DOI: 10.1016/j.jaad.2021.01.023] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/10/2020] [Accepted: 01/06/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND COVID-19 is associated with a wide range of skin manifestations. OBJECTIVE To describe the clinical characteristics of COVID-19-associated skin manifestations and explore the relationships among the 6 main cutaneous phenotypes and systemic findings. METHODS Twenty-one Italian Dermatology Units were asked to collect the demographic, clinical, and histopathologic data of 200 patients with COVID-19-associated skin manifestations. The severity of COVID-19 was classified as asymptomatic, mild, moderate, or severe. RESULTS A chilblain-like acral pattern was significantly associated with a younger age (P < .0001) and, after adjusting for age, significantly associated with less severe COVID-19 (P = .0009). However, the median duration of chilblain-like lesions was significantly longer than that of the other cutaneous manifestations taken together (P < .0001). Patients with moderate/severe COVID-19 were more represented than those with asymptomatic/mild COVID-19 among the patients with cutaneous manifestations other than chilblain-like lesions, but only the confluent erythematous/maculo-papular/morbilliform phenotype was significantly associated with more severe COVID-19 (P = .015), and this significance disappeared after adjustment for age. LIMITATIONS Laboratory confirmation of COVID-19 was not possible in all cases. CONCLUSIONS After adjustment for age, there was no clear-cut spectrum of COVID-19 severity in patients with COVID-19-related skin manifestations, although chilblain-like acral lesions were more frequent in younger patients with asymptomatic/pauci-symptomatic COVID-19.
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Affiliation(s)
- Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
| | - Giovanni Genovese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Chiara Moltrasio
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | - Valeria Gaspari
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Pamela Vezzoli
- Dermatology Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | | | - Cosimo Misciali
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Paolo Sena
- Dermatology Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Annalisa Patrizi
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Pietro Quaglino
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Renato Arco
- Statistician, Italian Ministry of Universities and Research, Milan, Italy
| | - Marzia Caproni
- Division of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Miriam Rovesti
- Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giorgio Bordin
- Internal Medicine, Piccole Figlie Hospital, Parma, Italy
| | | | - Concetta Potenza
- D. Innocenzi Dermatology Unit, Sapienza University of Rome, Polo Pontino, Rome, Italy
| | - Claudio Guarneri
- Department of Dermatology, University of Messina, Messina, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Carlo Tomasini
- Institute of Dermatology, Department of Clinical-Surgical, Diagnostic, and Pediatric Science, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Mariarita Sorci
- Dermatology Unit, Department of Surgery, Infermi Hospital Rimini, AUSL Romagna, Rimini, Italy
| | - Maurizio Lombardo
- Dermatology Department, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Andrea Conti
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest in Transplant, Oncological and Regenerative Medicine, Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanni Casazza
- L. Sacco Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - Ketty Peris
- Institute of Dermatology, Catholic University of Rome, Rome, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Emilio Berti
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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44
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Genovese G, Moltrasio C, Berti E, Marzano AV. Skin Manifestations Associated with COVID-19: Current Knowledge and Future Perspectives. Dermatology 2020; 237:1-12. [PMID: 33232965 PMCID: PMC7801998 DOI: 10.1159/000512932] [Citation(s) in RCA: 142] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/10/2020] [Indexed: 11/28/2022] Open
Abstract
Background Coronavirus disease-19 (COVID-19) is an ongoing global pandemic caused by the “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2), which was isolated for the first time in Wuhan (China) in December 2019. Common symptoms include fever, cough, fatigue, dyspnea and hypogeusia/hyposmia. Among extrapulmonary signs associated with COVID-19, dermatological manifestations have been increasingly reported in the last few months. Summary The polymorphic nature of COVID-19-associated cutaneous manifestations led our group to propose a classification, which distinguishes the following six main clinical patterns: (i) urticarial rash, (ii) confluent erythematous/maculopapular/morbilliform rash, (iii) papulovesicular exanthem, (iv) chilblain-like acral pattern, (v) livedo reticularis/racemosa-like pattern, (vi) purpuric “vasculitic” pattern. This review summarizes the current knowledge on COVID-19-associated cutaneous manifestations, focusing on clinical features and therapeutic management of each category and attempting to give an overview of the hypothesized pathophysiological mechanisms of these conditions.
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Affiliation(s)
- Giovanni Genovese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Chiara Moltrasio
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Emilio Berti
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy, .,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy,
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45
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Liu J, Li Y, Liu L, Hu X, Wang X, Hu H, Hu Z, Zhou Y, Wang M. Infection of human sweat glands by SARS-CoV-2. Cell Discov 2020; 6:84. [PMID: 33298845 PMCID: PMC7661176 DOI: 10.1038/s41421-020-00229-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/12/2020] [Indexed: 01/07/2023] Open
Affiliation(s)
- Jia Liu
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei 430071, China
| | - Yufeng Li
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei 430071, China
| | - Liang Liu
- Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Xudong Hu
- Wuhan Jinyin-tan Hospital, Wuhan, Hubei 430023, China
| | - Xi Wang
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei 430071, China
| | - Hengrui Hu
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei 430071, China
| | - Zhihong Hu
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei 430071, China.
| | - Yiwu Zhou
- Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
| | - Manli Wang
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei 430071, China.
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46
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Abstract
The new pandemic COVID-19 is now recognised as a multisystem disease. Variety of skin lesions have been reported in 0.2-20.4% of cases of COVID-19. In some cases of COVID-19, skin lesions have been reported as the initial or the only manifestation. We are reporting a case of bilateral palmar erythema as the sole manifestation of COVID-19 in a 37-year-old female who had a family history of COVID-19 like illness and was later found positive for anti-SARS-CoV-2 antibodies.
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47
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Leung TYM, Chan AYL, Chan EW, Chan VKY, Chui CSL, Cowling BJ, Gao L, Ge MQ, Hung IFN, Ip MSM, Ip P, Lau KK, Lau CS, Lau LKW, Leung WK, Li X, Luo H, Man KKC, Ng VWS, Siu CW, Wan EYF, Wing YK, Wong CSM, Wong KHT, Wong ICK. Short- and potential long-term adverse health outcomes of COVID-19: a rapid review. Emerg Microbes Infect 2020; 9:2190-2199. [PMID: 32940572 PMCID: PMC7586446 DOI: 10.1080/22221751.2020.1825914] [Citation(s) in RCA: 115] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has resulted in millions of patients
infected worldwide and indirectly affecting even more individuals through disruption of
daily living. Long-term adverse outcomes have been reported with similar diseases from
other coronaviruses, namely Middle East Respiratory Syndrome (MERS) and Severe Acute
Respiratory Syndrome (SARS). Emerging evidence suggests that COVID-19 adversely affects
different systems in the human body. This review summarizes the current evidence on the
short-term adverse health outcomes and assesses the risk of potential long-term adverse
outcomes of COVID-19. Major adverse outcomes were found to affect different body systems:
immune system (including but not limited to Guillain-Barré syndrome and paediatric
inflammatory multisystem syndrome), respiratory system (lung fibrosis and pulmonary
thromboembolism), cardiovascular system (cardiomyopathy and coagulopathy), neurological
system (sensory dysfunction and stroke), as well as cutaneous and gastrointestinal
manifestations, impaired hepatic and renal function. Mental health in patients with
COVID-19 was also found to be adversely affected. The burden of caring for COVID-19
survivors is likely to be huge. Therefore, it is important for policy makers to develop
comprehensive strategies in providing resources and capacity in the healthcare system.
Future epidemiological studies are needed to further investigate the long-term impact on
COVID-19 survivors.
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Affiliation(s)
- T Y M Leung
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - A Y L Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - E W Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - V K Y Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - C S L Chui
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.,Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.,Department of Social Work and Social Administration, Faculty of Social Science, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - B J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - L Gao
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - M Q Ge
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - I F N Hung
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - M S M Ip
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - P Ip
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - K K Lau
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - C S Lau
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - L K W Lau
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - W K Leung
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - X Li
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.,Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - H Luo
- Department of Social Work and Social Administration, Faculty of Social Science, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.,Department of Computer Science, Faculty of Engineering, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - K K C Man
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.,Research Department of Practice and Policy, UCL School of Pharmacy, London, UK
| | - V W S Ng
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - C W Siu
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - E Y F Wan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.,Department of Family Medicine and Primary Care, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Y K Wing
- Department of Psychiatry, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - C S M Wong
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.,Department of Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - K H T Wong
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - I C K Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.,Research Department of Practice and Policy, UCL School of Pharmacy, London, UK
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