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Curtis KK, Dillan MM, Sharma TR, Piktel J. COVID-19 infection increases the development of Stevens-Johnson syndrome and toxic epidermal necrolysis: A retrospective cohort analysis. J Am Acad Dermatol 2024:S0190-9622(24)00417-1. [PMID: 38423469 DOI: 10.1016/j.jaad.2024.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 02/15/2024] [Accepted: 02/20/2024] [Indexed: 03/02/2024]
Affiliation(s)
- Kristen K Curtis
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio.
| | - Meghan M Dillan
- Department of Emergency Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Timmie R Sharma
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Dermatology, University Hospitals, Cleveland, Ohio
| | - Joseph Piktel
- Department of Emergency Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Emergency Medicine, Metrohealth Medical Center, Cleveland, Ohio
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Pour Mohammad A, Noroozi E, Mesgarha MG, Shayanfar N, Goodarzi A. Interesting Mucocutaneous Manifestations in COVID-19 Infection or Vaccination Confirmed by Histopathology: A Case Series. Case Rep Dermatol 2024; 16:21-34. [PMID: 38298760 PMCID: PMC10829034 DOI: 10.1159/000535739] [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: 06/27/2023] [Accepted: 12/03/2023] [Indexed: 02/02/2024] Open
Abstract
Introduction Mucocutaneous complications or adverse events due to SARS-CoV-2 infection or vaccination have been well delineated in the literature, respectively. Most eruptions are considered mild and self-limiting; however, for the atypical cases with a tentative clinical diagnosis, performing a biopsy and histopathological assessment is pivotal to confirm the diagnosis and subsequently prescribe a more tailored treatment. Despite the diverse reporting of such incidents globally, most studies restrict the rate of biopsied cases to less than 15%. Case Presentations This case series elucidates 20 patients referred to the tertiary dermatology clinic, including 14 COVID-19 infection-related eruptions such as lichen planus (LP), cutaneous vasculitis, pityriasis rosea (PR), discoid lupus erythematosus, guttate psoriasis, sarcoidosis, Raynaud's phenomenon, non-specific lesions resembling genital warts, Beau's line, and one severe case of purpura fulminans with a promising outcome. Moreover, we presented six vaccine-induced cases comprising LP, urticarial vasculitis, PR, parapsoriasis, and localized morphea. The diagnosis of all challenging cases has been proven by histopathological evaluation. We included pertaining anamnesis details of each patient and vivid classifying images to pinpoint the morphologic features of each condition. Discussion In line with our previous studies, the vaccine-induced eruptions were less severe compared to infection-related complications of COVID-19 and are mostly controllable by antihistamines and corticosteroid administration. Therefore, reporting such events should not impede COVID-19 vaccination in the general population.
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Affiliation(s)
- Arash Pour Mohammad
- Faculty of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Elahe Noroozi
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Nasrin Shayanfar
- Department of Pathology, Rasool Akram Medical Complex, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Atefi N, Goodarzi A, Riahi T, Khodabandehloo N, Talebi Taher M, Najar Nobari N, Seirafianpour F, Mahdi Z, Baghestani A, Valizadeh R. Evaluation of the efficacy and safety of oral N-acetylcysteine in patients with COVID-19 receiving the routine antiviral and hydroxychloroquine protocol: A randomized controlled clinical trial. Immun Inflamm Dis 2023; 11:e1083. [PMID: 38018602 PMCID: PMC10659758 DOI: 10.1002/iid3.1083] [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: 06/13/2023] [Revised: 10/25/2023] [Accepted: 10/31/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND The current absence of gold-standard or all-aspect favorable therapies for COVID-19 renders a focus on multipotential drugs proposed to prevent or treat this infection or ameliorate its signs and symptoms vitally important. The present well-designed randomized controlled trial (RCT) sought to evaluate the efficacy and safety of N-acetylcysteine (NAC) as adjuvant therapy for 60 hospitalized Iranian patients with COVID-19. METHODS Two 30-person diets, comprising 15 single diets of Kaletra (lopinavir/ritonavir) + hydroxychloroquine (HCQ) with/without NAC (600 mg TDS) and atazanavir/ritonavir + HCQ with/without NAC (600 mg TDS), were administered in the study. RESULTS At the end of the study, a further decrease in C-reactive protein was observed in the NAC group (P = 0.008), and no death occurred in the atazanavir/ritonavir + HCQ + NAC group, showing that the combination of these drugs may reduce mortality. The atazanavir/ritonavir + HCQ and atazanavir/ritonavir + NAC groups exhibited the highest O2 saturation at the end of the study and a significant rise in O2 saturation following intervention commencement, including NAC (P > 0.05). Accordingly, oral or intravenous NAC, if indicated, may enhance O2 saturation, blunt the inflammation trend (by reducing C-reactive protein), and lower mortality in hospitalized patients with COVID-19. CONCLUSION The NAC could be more effective as prophylactic or adjuvant therapy in stable non-severe cases of COVID-19 with a particularly positive role in the augmentation of O2 saturation and faster reduction of the CRP level and inflammation or could be effective for better controlling of COVID-19 or its therapy-related side effects.
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Affiliation(s)
- Najmolsadat Atefi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of MedicineIran University of Medical SciencesTehranIran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of MedicineIran University of Medical SciencesTehranIran
| | - Taghi Riahi
- Department of Internal Medicine, School of MedicineIran University of Medical SciencesTehranIran
| | - Niloofar Khodabandehloo
- Department of Geriatric Medicine, School of MedicineIran University of Medical SciencesTehranIran
| | - Mahshid Talebi Taher
- Department of Infectious Disease, School of Medicine, Antimicrobial Resistance Research Center, Immunology and Infectious Disease Research InstituteIran University of Medical SciencesTehranIran
| | - Niloufar Najar Nobari
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of MedicineIran University of Medical SciencesTehranIran
| | | | - Zeinab Mahdi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of MedicineIran University of Medical SciencesTehranIran
| | - Amir Baghestani
- Department of General Medicine, Rasool Akram Medical Complex, School of MedicineIran University of Medical SciencesTehranIran
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Bidari A, Zarei E, Hassanzadeh M, Gholizadeh Mesgarha M, Pour Mohammad A, Shafiei R, Mortaja M, Naderkhani M. Development of a Scoring Method Based on a Chest CT Scan to Determine the Outcomes of COVID-19 Patients. Cureus 2023; 15:e47354. [PMID: 38022268 PMCID: PMC10657166 DOI: 10.7759/cureus.47354] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction As COVID-19 shifts from pandemic urgency to endemic management, healthcare systems are faced with the evolving challenge of providing optimized care and adept resource allocation in this evolving landscape of the disease. However, the timely management and accurate assessment of disease severity remains a cornerstone of effective treatment. This study presents a pioneering scoring system, based on the primary chest CT scan findings, to predict patient outcomes and to equip clinicians with a tool that can expedite decision-making. Method A retrospective cohort study was conducted involving 406 confirmed COVID-19 cases referred to two of our hospitals in Tehran, between February and April 2020. Radiographic and CT scan data were sourced from the imaging archive system and evaluated by a certified radiologist. We devised distinct severity scores for CT findings, demographic factors, and clinical indicators. These were synthesized into a comprehensive severity score to forecast critical patient outcomes, such as mortality, ICU admission, intubation, or extended hospitalization. Of the total cases, 161 (39.7%) were classified as severe, while 245 (60%) fell into the low or moderate severity category. Results The mean score of demographic, CT scan, and clinical characteristics was significantly higher for those in the severe COVID-19 than the non-severe group. The cutoff score for predicting the outcomes in COVID-19 patients for demographic, clinical, and chest CT scan factors was 2.5, 9.5, and 8.5, respectively. Multivariate analysis indicated that each unit increase in these scores elevated the odds of fatal outcomes by 24%, 2.8%, and 12%, respectively. Then, using the comprehensive severity score, which is the sum of the above scores, we further predicted the disease severity. Conclusion The findings suggest that our innovative scoring system, based on initial chest CT scan findings, serves as a robust predictor of COVID-19 outcomes.
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Affiliation(s)
- Ali Bidari
- Department of Rheumatology, Iran University of Medical Sciences, Tehran, IRN
| | - Elham Zarei
- Department of Radiology, Iran University of Medical Sciences, Tehran, IRN
| | - Morteza Hassanzadeh
- Department of Internal Medicine, Iran University of Medical Sciences, Tehran, IRN
| | | | | | - Reyhaneh Shafiei
- School of Medicine, Iran University of Medical Sciences, Tehran, IRN
| | - Mahsa Mortaja
- Cancer Research Center, Tehran University of Medical Sciences, Tehran, IRN
| | - Mahya Naderkhani
- Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, IRN
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Ică OM, Mitroi G, Ianoşi SL, Tutunaru CV, Leru PM, Matei D, Avramescu ET, Tănasie CA, Mitroi IB, Neagoe CD, Cazacu SM. Defining the short-term and long-term skin manifestations of COVID-19: insights after more than three years of the pandemic. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2023; 64:291-304. [PMID: 37867347 PMCID: PMC10720941 DOI: 10.47162/rjme.64.3.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/22/2023] [Indexed: 10/24/2023]
Abstract
AIM This review aimed to assess the impact of coronavirus disease 2019 (COVID-19) on skin health to establish a classification of the skin lesions that occur most frequently during the disease and whether a particular category of skin damage is more likely to occur both in the short term and in the long term. METHODS We conducted a literature search of the PubMed database. Ultimately, 109 articles were included in this review. The exact phrases∕syntax and connectors used for the database search∕query were as follows: "Coronavirus and skin", "COVID-19 and skin", "SARS-CoV-2 and skin", "Coronavirus cutaneous manifestations", "COVID-19 cutaneous manifestations", "SARS-CoV-2 cutaneous manifestations", "Coronavirus dermatology", "SARS-CoV-2 and dermatology", "COVID-19 and dermatology", "COVID-19 and skin eruption", "Coronavirus and skin rash", "COVID-19 and hair", "Coronavirus and hair", "Coronavirus and nails", "SARS-CoV-2 and hair", and "SARS-CoV-2 and nails". Only articles with abstracts referring strictly to cutaneous manifestations of COVID-19 were chosen. Articles without abstracts were not considered. RESULTS We established six of the most frequently reported clinical patterns associated with COVID-19 and their probability of occurring during COVID-19 disease evolution based on the current literature reports. We did not identify the particular types of skin lesions that are most prone to long-term persistence; most such cases are rare, and no conclusion can be drawn based on them. CONCLUSIONS Apart from classified COVID-19-related skin disorders, this pandemic has been a challenge for dermatologists and a wide range of cutaneous side effects related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) treatments have been reported. We are aware of other polymorphic clinical presentations, with novel data being reported periodically, but the pathophysiological mechanisms and evolution are largely unknown.
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Affiliation(s)
- Oana Maria Ică
- Department of Dermatology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - George Mitroi
- Department of Urology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Simona Laura Ianoşi
- Department of Dermatology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Cristina Violeta Tutunaru
- Department of Dermatology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Polliana Mihaela Leru
- Department of Family Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Daniela Matei
- Department of Medical Rehabilitation, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | | | - Cornelia Andreea Tănasie
- Department of Physiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Iulia Bianca Mitroi
- Medical Student, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Carmen Daniela Neagoe
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Sergiu Marian Cazacu
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
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Bidari A, Asgarian S, Pour Mohammad A, Naderi D, Anaraki SR, Gholizadeh Mesgarha M, Naderkhani M. Immune thrombocytopenic purpura secondary to COVID-19 vaccination: A systematic review. Eur J Haematol 2023; 110:335-353. [PMID: 36562217 PMCID: PMC9880659 DOI: 10.1111/ejh.13917] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/06/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION This systematic review aimed to retrieve patients diagnosed with de novo immune thrombocytopenic purpura (ITP) after COVID-19 immunization to determine their epidemiological characteristics, clinical course, therapeutic strategies, and outcome. MATERIALS AND METHODS We conducted the review using four major databases, comprising PubMed, Scopus, Web of Science, and the Cochrane library, until April 2022. A systematic search was performed in duplicate to access eligible articles in English. Furthermore, a manual search was applied to the chosen papers' references to enhance the search sensitivity. Data were extracted and analyzed with the SPSS 20.1 software. RESULTS A total of 77 patients with de novo COVID-19 vaccine-associated ITP were identified from 41 studies, including 31 case reports and 10 case series. The median age of patients who developed COVID-19 vaccine-associated ITP was 54 years (IQR 36-72 years). The mRNA-based COVID-19 vaccines, including BNT16B2b2 and mRNA-1273, were most implicated (75.4%). Those were followed by the adenovirus vector-based vaccines, inclusive of ChAdOx1 nCoV-19 and vAd26.COV2.S. No report was found relating ITP to other COVID-19 vaccines. Most cases (79.2%) developed ITP after the first dose of COVID-19 vaccination. 75% of the patients developed ITP within 12 days of vaccination, indicating a shorter lag time compared to ITP after routine childhood vaccinations. Sixty-seven patients (87%) patients were hospitalized. The management pattern was similar to primary ITP, and systemic glucocorticoids, IVIg, or both were the basis of the treatment in most patients. Most patients achieved therapeutic goals; only two individuals required a secondary admission, and one patient who presented with intracranial hemorrhage died of the complication. CONCLUSIONS De novo ITP is a rare complication of COVID-19 vaccination, and corresponding reports belong to mRNA-based and adenovirus vector-based vaccines, in order of frequency. This frequency pattern may be related to the scale of administration of individual vaccines and their potency in inducing autoimmunity. The more the COVID-19 vaccine is potent to induce antigenic challenge, the shorter the lag time would be. Most patients had a benign course and responded to typical treatments of primary ITP.
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Affiliation(s)
- Ali Bidari
- Department of Rheumatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Sara Asgarian
- Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran
| | - Arash Pour Mohammad
- Faculty of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Delaram Naderi
- Faculty of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | | | | | - Mahya Naderkhani
- Department of Emergency medicine, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
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A Systematic Review of Histopathologic Surveys on Mucocutaneous Biopsies in Patients Developed COVID-19 Vaccine-Related Dermatologic Manifestations. Am J Dermatopathol 2023; 45:1-27. [PMID: 36484603 DOI: 10.1097/dad.0000000000002320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
ABSTRACT Coronavirus 2 is an infectious agent primarily identified as the cause of a pandemic viral pneumonia. With the mass vaccination against this virus, one of the health issues is the safety of currently available vaccines considering their adverse reactions. This systematic review was conducted to assess and summarize all reported data on histopathologic findings associated with mucocutaneous reactions that developed after COVID-19 vaccination for a better pathophysiology interpretation and clinical management of these reactions. A systematic search was performed in PubMed, Web of Science, and Scopus databases as well as Google Scholar engine for relevant English articles published till July 1, 2022. This review includes 131 studies with a total number of 287 cases. Eruptions that underwent a biopsy were mostly described as erythematous maculopapular, papulosquamous, vasculitis-like, lichenoid, or urticarial lesions. Histopathology revealed spongiosis, interstitial, and perivascular lymphohistiocytic infiltration, erythrocyte extravasation, parakeratosis, endothelial inflammation, and the like. Findings were highly consistent with morbilliform erythema, psoriasiform dermatosis, leukocytoclastic vasculitis, and lichenoid or urticarial drug reactions. The majority of these reactions had a mild nature and were primarily observed in patients with underlying health conditions. Microscopic evaluation was also consistent with transient inflammatory changes, and features like neutrophilic infiltrates, subcorneal pustules, and vasculopathy were less frequently reported than what seen in COVID infection. Therefore, dermatologic reactions developing after vaccination in the general population should not hinder a complete vaccination.
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Zou H, Daveluy S. Toxic epidermal necrolysis and Stevens-Johnson syndrome after COVID-19 infection and vaccination. Australas J Dermatol 2022; 64:e1-e10. [PMID: 36484649 PMCID: PMC9878214 DOI: 10.1111/ajd.13958] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/11/2022] [Accepted: 11/20/2022] [Indexed: 12/14/2022]
Abstract
Stevens-Johnson Syndrome (SJS) is a rare but severe skin reaction characterized by blistering and peeling of the skin and ulcerations of mucous membranes; toxic epidermal necrolysis (TEN) is a subset of SJS characterized by the involvement of >30% of the skin. Though previously associated with drugs and infections, discussions on the association between TEN/SJS and COVID-19 have been limited. We present a review of TEN/SJS after COVID-19 infection and vaccination. Literature searches were conducted on PubMed and Google Scholar from 2019 to 8/2022. Thirty-eight articles were selected based on subject relevance, and references within selected articles were also screened for relevance. As of 8/2022, there have been 34 published cases of TEN, SJS, and SJS-TEN overlap after COVID-19 infection and vaccination, including 12 cases after vaccination and 22 cases after infection. Multiple authors hypothesize that virotopes or excipients in COVID-19 vaccines can activate T-cells or cytokines to induce TEN/SJS. Meanwhile, some hypothesize that COVID-19 infection induces immune activation that can trigger TEN/SJS or increase susceptibility to drug-induced TEN/SJS. Treatments for post-infection and post-vaccination TEN/SJS vary significantly. We recommend remaining vigilant for this rare and severe potential complication.
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Affiliation(s)
- Henry Zou
- Michigan State University College of Human MedicineGrand RapidsMichiganUSA
| | - Steven Daveluy
- Department of DermatologyWayne State University School of MedicineDetroitMichiganUSA
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Singh R, Freeman EE. Viruses, Variants, and Vaccines: How COVID-19 Has Changed the Way We Look at Skin. CURRENT DERMATOLOGY REPORTS 2022; 11:289-312. [PMID: 36274754 PMCID: PMC9574791 DOI: 10.1007/s13671-022-00370-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Rhea Singh
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 50 Staniford St, Boston, MA 02114 USA
- Virginia Commonwealth University School of Medicine, Richmond, VA USA
| | - Esther E. Freeman
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 50 Staniford St, Boston, MA 02114 USA
- Medical Practice Evaluation Center, Mongan Institute, Massachusetts General Hospital, Boston, MA USA
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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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Baj J, Forma A, Teresińska B, Tyczyńska M, Zembala J, Januszewski J, Flieger J, Buszewicz G, Teresiński G. How Does SARS-CoV-2 Affect Our Eyes-What Have We Learnt So Far about the Ophthalmic Manifestations of COVID-19? J Clin Med 2022; 11:3379. [PMID: 35743449 PMCID: PMC9225256 DOI: 10.3390/jcm11123379] [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] [Received: 04/05/2022] [Revised: 05/21/2022] [Accepted: 06/08/2022] [Indexed: 12/03/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has become a worldwide threat resulting in a pandemic in 2020. SARS-CoV-2 infection manifests itself as coronavirus disease 2019 (COVID-19) that is evidenced in a vast number of either specific or nonspecific symptoms. Except for typical (but nonspecific) symptoms such as fever, dry cough, or muscle weakness, the infected patients might also present atypical symptoms including neurological, dermatological, or ophthalmic manifestations. This paper summarizes the current state of knowledge regarding the onset, progression, and types of ophthalmic symptoms induced by SARS-CoV-2 infection recognized amongst the infected patients.
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Affiliation(s)
- Jacek Baj
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (M.T.); (J.J.)
| | - Alicja Forma
- Chair and Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (B.T.); (G.B.); (G.T.)
| | - Barbara Teresińska
- Chair and Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (B.T.); (G.B.); (G.T.)
| | - Magdalena Tyczyńska
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (M.T.); (J.J.)
| | - Julita Zembala
- Department of Ophthalmology, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Jacek Januszewski
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (M.T.); (J.J.)
| | - Jolanta Flieger
- Department of Analytical Chemistry, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Grzegorz Buszewicz
- Chair and Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (B.T.); (G.B.); (G.T.)
| | - Grzegorz Teresiński
- Chair and Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (B.T.); (G.B.); (G.T.)
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Seirafianpour F, Pourriyahi H, Gholizadeh Mesgarha M, Pour Mohammad A, Shaka Z, Goodarzi A. A systematic review on mucocutaneous presentations after COVID-19 vaccination and expert recommendations about vaccination of important immune-mediated dermatologic disorders. Dermatol Ther 2022; 35:e15461. [PMID: 35316551 PMCID: PMC9111423 DOI: 10.1111/dth.15461] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 11/29/2022]
Abstract
With dermatologic side effects being fairly prevalent following vaccination against COVID-19, and the multitude of studies aiming to report and analyze these adverse events, the need for an extensive investigation on previous studies seemed urgent, in order to provide a thorough body of information about these post-COVID-19 immunization mucocutaneous reactions. To achieve this goal, a comprehensive electronic search was performed through the international databases including Medline (PubMed), Scopus, Cochrane, Web of science, and Google scholar on July 12, 2021, and all articles regarding mucocutaneous manifestations and considerations after COVID-19 vaccine administration were retrieved using the following keywords: COVID-19 vaccine, dermatology considerations and mucocutaneous manifestations. A total of 917 records were retrieved and a final number of 180 articles were included in data extraction. Mild, moderate, severe and potentially life-threatening adverse events have been reported following immunization with COVID vaccines, through case reports, case series, observational studies, randomized clinical trials, and further recommendations and consensus position papers regarding vaccination. In this systematic review, we categorized these results in detail into five elaborate tables, making what we believe to be an extensively informative, unprecedented set of data on this topic. Based on our findings, in the viewpoint of the pros and cons of vaccination, mucocutaneous adverse events were mostly non-significant, self-limiting reactions, and for the more uncommon moderate to severe reactions, guidelines and consensus position papers could be of great importance to provide those at higher risks and those with specific worries of flare-ups or inefficient immunization, with sufficient recommendations to safely schedule their vaccine doses, or avoid vaccination if they have the discussed contra-indications.
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Affiliation(s)
- Farnoosh Seirafianpour
- Student Research Committee, School of MedicineIran University of Medical SciencesTehranIran
| | - Homa Pourriyahi
- Student Research Committee, School of MedicineIran University of Medical SciencesTehranIran
| | | | - Arash Pour Mohammad
- Student Research Committee, School of MedicineIran University of Medical SciencesTehranIran
| | - Zoha Shaka
- Faculty of MedicineIran University of Medical SciencesTehranIran
- Systematic Review and Meta‐Analysis Expert Group (SRMEG)Universal Scientific Education and Research NetworkTehranIran
| | - Azadeh Goodarzi
- Department of DermatologyRasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical SciencesTehranIran
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Behrangi E, Sadeghzadeh‐Bazargan A, Salimi N, Shaka Z, Feyz Kazemi MH, Goodarzi A. Erythrodermic flare‐up of psoriasis with COVID‐19 infection: A report of two cases and a comprehensive review of literature focusing on the mutual effect of psoriasis and COVID‐19 on each other along with the special challenges of the pandemic. Clin Case Rep 2022; 10:e05722. [PMID: 35474976 PMCID: PMC9019895 DOI: 10.1002/ccr3.5722] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/12/2022] [Accepted: 03/28/2022] [Indexed: 12/11/2022] Open
Affiliation(s)
- Elham Behrangi
- Department of Dermatology Rasool Akram Medical Complex Clinical Research Development Center (RCRDC) School of Medicine Iran University of Medical Sciences (IUMS) Tehran Iran
| | - Afsaneh Sadeghzadeh‐Bazargan
- Department of Dermatology Rasool Akram Medical Complex Clinical Research Development Center (RCRDC) School of Medicine Iran University of Medical Sciences (IUMS) Tehran Iran
| | - Nastaran Salimi
- School of Medicine Iran University of Medical Sciences Tehran Iran
| | - Zoha Shaka
- School of Medicine Iran University of Medical Sciences Tehran Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA) Universal Scientific Education and Research Network (USERN) Tehran Iran
| | | | - Azadeh Goodarzi
- Department of Dermatology Rasool Akram Medical Complex Clinical Research Development Center (RCRDC) School of Medicine Iran University of Medical Sciences (IUMS) Tehran Iran
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14
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Pour Mohammad A, Mashayekhi F, Seirafianpour F, Gholizadeh Mesgarha M, Goodarzi A. COVID‐19 and COVID‐19 vaccine‐related dermatological reactions: An interesting case series with a narrative review of the potential critical and non‐critical mucocutaneous adverse effects related to virus, therapy, and the vaccination. Clin Case Rep 2022; 10:e05775. [PMID: 35498347 PMCID: PMC9040420 DOI: 10.1002/ccr3.5775] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 12/18/2022] Open
Abstract
This narrative review article was conducted to lay out a summarized but exhaustive review of current literature over mucocutaneous manifestations in 4 dimensions of SARS‐CoV‐2 pandemic: virus itself, treatment‐related, vaccine‐induced, and alteration of chronic dermatologic diseases following infection. Virus and vaccine‐related were mainly self‐limited and non‐severe. Treatment‐related reactions could be life‐threatening.
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Affiliation(s)
| | - Farzaneh Mashayekhi
- Department of General Medicine Rasool Akram Medical Complex Iran University of Medical Sciences (IUMS) Tehran Iran
| | - Farnoosh Seirafianpour
- Student Research Committee School of Medicine Iran University of Medical Sciences Tehran Iran
| | | | - Azadeh Goodarzi
- Department of Dermatology Rasool Akram Medical Complex Clinical Research Development Center (RCRDC) School of Medicine Iran University of Medical Sciences Tehran Iran
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15
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Kalantari Y, Sadeghzadeh-Bazargan A, Aryanian Z, Hatami P, Goodarzi A. First reported case of delayed-type hypersensitivity reaction to non-hyaluronic acid Polycaprolactone dermal filler following COVID-19 vaccination: A case report and a review of the literature. Clin Case Rep 2022; 10:e05343. [PMID: 35145687 PMCID: PMC8818279 DOI: 10.1002/ccr3.5343] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/01/2022] [Accepted: 01/13/2022] [Indexed: 12/23/2022] Open
Abstract
Cases of filler reactions after COVID‐19 vaccination have been reported. Here, we present the first case of delayed‐type reaction (DTR) to non‐hyaluronic acid Polycaprolactone dermal filler after the second dose of Sinopharm COVID‐19 vaccine which was improved with administration of topical and intralesional steroids.
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Affiliation(s)
- Yasamin Kalantari
- Department of Dermatology Razi Hospital Tehran University of Medical Sciences Tehran Iran
| | - Afsaneh Sadeghzadeh-Bazargan
- Rasool Akram Medical Complex Clinical Research Development Center (RCRDC) School of Medicine Iran University of Medical Sciences Tehran Iran
| | - Zeinab Aryanian
- Autoimmune Bullous Diseases Research Center Tehran University of Medical Sciences Tehran Iran.,Department of Dermatology Babol University of Medical Sciences Babol Iran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research Center Tehran University of Medical Sciences Tehran Iran
| | - Azadeh Goodarzi
- Rasool Akram Medical Complex Clinical Research Development Center (RCRDC) School of Medicine Iran University of Medical Sciences Tehran Iran.,Skin and Stem Cell Research Center Tehran University of Medical Sciences Tehran Iran
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16
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Haraguchi S, Tsubokura S, Ozasa K, Sakuma H, Ito S. Pediatric Stevens-Johnson syndrome associated with severe acute respiratory syndrome coronavirus 2 infection. Pediatr Int 2022; 64:e15366. [PMID: 36165959 PMCID: PMC9537940 DOI: 10.1111/ped.15366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/08/2022] [Accepted: 09/20/2022] [Indexed: 01/24/2023]
Affiliation(s)
| | - Shin Tsubokura
- Department of Pediatrics, Yokohama Rosai Hospital, Yokohama, Japan
| | - Koji Ozasa
- Department of Pediatrics, Yokohama Rosai Hospital, Yokohama, Japan
| | - Hiroyuki Sakuma
- Department of Pediatrics, Yokohama Rosai Hospital, Yokohama, Japan
| | - Shuichi Ito
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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17
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Lotfi Z, Haghighi A, Akbarzadehpasha A, Mozafarpoor S, Goodarzi A. Pansclerotic Morphea Following COVID-19: A Case Report and Review of Literature on Rheumatologic and Non-rheumatologic Dermatologic Immune-Mediated Disorders Induced by SARS-CoV-2. Front Med (Lausanne) 2021; 8:728411. [PMID: 34746174 PMCID: PMC8564069 DOI: 10.3389/fmed.2021.728411] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/14/2021] [Indexed: 12/12/2022] Open
Abstract
While mucocutaneous manifestations of COVID-19 have been frequently reported and added to our knowledge every day during the pandemic, another issue is the COVID-related diseases that can present as intensified lesions of underlying diseases, a new disease, or changes in the behavior of an old lesion. Given that immune system overreaction and cytokine storm are among the most prominent events in COVID-19, the incidence of autoimmune diseases is expected to increase after COVID-19, as confirmed in several reports. To increase the body of knowledge about short- and long-term outcomes of COVID-19 for specialists, it is essential that similar cases be reported and collected for years to come. The present study investigated a case of pansclerotic morphea that rapidly progressed a few weeks after infection with COVID-19 in a 57-year-old woman with no history of any autoimmune skin or rheumatic diseases. She was prescribed outpatient COVID-19 treatment of azithromycin, vitamins D and C, and then quarantined for 2 weeks. The manifestations of the disease were exacerbated at each follow-up and sampling visit at short intervals. This kind of pansclerotic morphea is reported for the first time.
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Affiliation(s)
- Zahra Lotfi
- Department of Dermatology, Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Dermatology, Rasool Akram Medical Complex, Iran University of Medical Sciences, Tehran, Iran
| | - Anousheh Haghighi
- Department of Rheumatology, Rasool Akram Medical Complex, Iran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Akbarzadehpasha
- Department of Internal Medicine, Rasool Akram Medical Complex, Iran University of Medical Sciences, Tehran, Iran
| | - Samaneh Mozafarpoor
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex, Iran University of Medical Sciences, Tehran, Iran
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