In a systematic literature review of the effects of long COVID-19 on the skin, researchers found that some patients experienced persistent cutaneous symptoms and pathological manifestations for several months after initial COVID-19 diagnosis or symptom resolution. The findings were presented at the 2022 Annual Meeting of the American Academy of Dermatology (AAD), held from March 25 to 29, 2022 in Boston, Massachusetts.
To characterize the cutaneous manifestations of long COVID, the researchers reviewed peer-reviewed studies that followed the clinical course of confirmed COVID-19 cases and documented persistent skin lesions after the initial diagnosis or resolution of symptoms. The literature search included studies published until May 1, 2021.
The researchers included 22 studies: 15 case reports, 5 case series, 1 cohort, and 1 cross sectional study. Combined, the studies described 236 patients with long COVID and cutaneous lesions. The patients ranged from 6 to 89 years of age; 69.5% were women and 20.3% men (10.2% not reported).
The researchers reported cutaneous manifestations of long COVID along with timing of onset and histopathology findings. The most common skin lesion reported was alopecia, which occurred in 83% of patients with long COVID. Other findings included pernio like (4.2%), maculopapular (1.7%), urticarial (0.8%), vesicular (0.4%), papulosquamous (0.4%), purpuric (0.4%), and other lesions (2.6%; 1 Kawasaki like, 1 cheilitis, 1 sarcoid granuloma, 1 onychomadesis, and 1 orange nail lesion). No specific lesions were reported for 6.4% of patients. Hospitalization and intubation was reported for 1 patient.
The timing of onset of lesions ranged from 7 to 180 days after initial COVID-19 diagnosis or symptom resolution. The duration of lesions ranged from 6 to 240 days. Patients’ histopathology reports described non- viral changes.
“Overall, these findings suggest that the morbidity of COVID-19 illness has been greatly overlooked. Patients experience cutaneous symptoms for over several months, resulting in significant impact to their lives and livelihoods,” concluded the researchers. “[F]urther investigation is needed to determine the full clinical spectrum, mechanism and prognostic significance of such skin lesions.”
Grover A, Choi F, Pei-Wang S. Long term cutaneous manifestations in COVID-19 patients: a systematic review. Presented at: the 2022 AAD Annual Meeting; March 25-29, 2022. Abstract/Poster 33624.
This article originally appeared on Dermatology Advisor