Abstract
BackgroundDespite being variable and poorly characterized, the reported cutaneous manifestations of coronavirus disease 2019 (COVID-19) are of increasing concern.MethodologyThis study aimed to determine the prevalence and possible association between COVID-19 and herpes simplex virus (HSV) infection. A nine-item questionnaire was sent to 120 polymerase chain reaction-confirmed COVID-19 patients with a response rate of 66.67%. This cross-sectional observational study included 80 patients with mild-to-moderate COVID-19 infection who did not require hospitalization or steroid therapy.ResultsOne or more HSV infections were observed in 28 patients (35%) with COVID-19 infection, including 10 (35.7%) males and 18 (64.29%) females. Of the 28 patients, fever was reported in 17 (75%) during COVID-19. Most of the respondents (78%) described a single HSV reactivation, 14.29% had two attacks, and 7.14% experienced three attacks. Compared to previous non-COVID-19-related HSV reactivation, the COVID-19-related attacks were more severe in 12 (42.85%) patients, equally severe in five (17.85%) patients, and less severe in one (3.57%) patient. Interestingly, 10 (35.71%) patients developed an initial symptomatic HSV attack during COVID-19 infection.ConclusionsThis study demonstrated a possible association between COVID-19 infection and primary HSV infection or reactivation. COVID-19 direct neuronal effect in addition to COVID-19-related psychological stress, fever, and immunological dysregulation could play a potential role in HSV reactivation or primary infection during COVID-19.
Highlights
For about a year the world has been under the grip of the coronavirus disease 2019 (COVID-19) pandemic
One or more herpes simplex virus (HSV) infections were observed in 28 patients (35%) with COVID-19 infection, including 10 (35.7%) males and 18 (64.29%) females
This study demonstrated a possible association between COVID-19 infection and primary HSV infection or reactivation
Summary
For about a year the world has been under the grip of the coronavirus disease 2019 (COVID-19) pandemic. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a member of the Coronaviridae family. In the 21st century, two other major respiratory disease outbreaks were caused by closely related coronaviruses, including the severe acute respiratory syndrome and the Middle East respiratory syndrome [2]. Respiratory manifestations seem to be predominant, an increasing number of COVID-19-related cutaneous manifestations have been reported, including maculopapular, urticarial, purpuric, chilblain-like, and vesicular eruptions. Other less commonly reported lesions include livedo reticularis-like, erythema multiforme-like, papulosquamous, necrotic lesions, and gangrene [3,4,5]. Despite being variable and poorly characterized, the reported cutaneous manifestations of coronavirus disease 2019 (COVID-19) are of increasing concern
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