Abstract
Background and objectives: A wide arrays of skin lesions occurred in the setting of COVID-19 infection. We aimed to estimate the incidence and types of skin lesions among hospitalized patients with COVID-19 infection. Methods: We conducted an observational cohort study on 369 hospitalized patients with COVID-19 infection at Basra Teaching Hospital for 3 months. We studied the incidence and types of skin lesions. Results: Among 369 hospitalized patients, skin lesions were developed in 5%. Of those who developed skin lesions, 33% were asymptomatic. Patients who developed skin lesions were younger (mean age of 40 ± 19.6 SD) and female (83.3%). The most frequent type of skin lesion was maculopapular 44.3% which occurred exclusively in the medical ward and half of them in asymptomatic patients. For pustular lesions, all were female, diabetic, in the ICU, in symptomatic patients with the highest levels of serum C-reactive proteins. Pseudo-chilblain lesions were reported only in younger female and half of patients were asymptomatic. Urticarial lesions were reported in the younger patients, two-thirds were symptomatic and in the ICU. Purpuric lesions were reported in the older patient who developed acute kidney injury. Extremities were the most common distribution of skin lesions in 38.8%. The mean latency period for development of skin lesions was 8.6 ± 9.1, the shortest for urticarial lesions and the longest for purpuric lesions. Conclusions: Different types of skin lesions were reported in patients with COVID-19 and may be the sole manifestations of the disease.
Highlights
A wide range of skin lesions was reported in patients with COVID-19 infection [1,2,3]
Among 369 hospitalized patients, skin lesions were developed in 5%
Skin lesions were more frequent in young females (83.3%)
Summary
From March 1, 2020, to June 1, 2020, 372 patients were admitted to Basra Teaching Hospital with a diagnosis of COVID-19 infection that was confirmed by polymerase chain reaction. The most common skin lesions were maculopapular in 44.3% with a mean duration was 5 ± 2.9 SD, 50% were itchy, 27.8% was painful and the most common site was the extremities in 38.8%.the mean time from symptoms in symptomatic patients to development of skin lesions was 8.6 days. The mean time from symptoms in symptomatic patients to development of skin lesions was 8.6 days, but 33% of patients developed skin lesions while asymptomatic. The higher frequency in some of these reports may reflect media attention to pseudochilblain lesions and the health care provider suggested this type of skin lesions even without laboratory confirmation whereas in our study, all pseudo-chilblain lesions (11.1%) were in laboratory-confirmed cases In these studies, after restriction to laboratory-confirmed cases, the most frequent skin lesions were maculopapular which was similar to our study findings.
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