Study: Patients with COVID-19 Experience Lasting Skin Problems

Six of the patients with pernio/chilblains were long haulers with toe symptoms lasting at least 60 days, with 2 lab-confirmed patients with COVID toes lasting longer than 130 days, according to the study.

A new analysis has found that some patients with coronavirus disease 2019 (COVID-19) have persistent skin-related symptoms long after their initial infection has cleared, mainly effecting “long haulers,” or patients who get better but do not seem to fully recover from COVID-19.

Researchers from Massachusetts General Hospital established an international registry for COVID-19 skin manifestations for the analysis in April 2020, in collaboration with the International League of Dermatological Societies and the American Academy of Dermatology. Further, clinicians were contacted in June and August to update COVID-19 laboratory test results and the duration of patients’ COVID-19 skin symptoms. The team defined long haulers as anyone with skin symptoms of COVID-19 that persisted for at least 60 days, according to the study.

Nearly 1000 cases of patients with skin manifestations of COVID-19 were evaluated by the researchers. Among 224 total suspected cases and 90 laboratory-confirmed cases of COVID-19 from 39 countries with information on symptom duration, the median duration of symptoms was 12 days. Additionally, rash-like morbilliform and urticarial eruptions lasted a median of 7 days and 4 days for patients with lab-confirmed COVID-19 with a maximum duration of 28 days.

Papulosquamous eruptions, or scaly papules and plaques, lasted a median of 20 days in lab-confirmed cases, with 1 confirmed long hauler eruption lasting 70 days. Further, pernio/chilblains, redness and swelling of the feet and hands labeled as “COVID toes,” lasted a median of 15 days in patients with suspected COVID-19 and 10 days in lab-confirmed cases.

Six of the patients with pernio/chilblains were long haulers with toe symptoms lasting at least 60 days, with 2 lab-confirmed patients with COVID toes lasting longer than 130 days, according to the study.

"Our findings reveal a previously unreported subset of patients with long-standing skin symptoms from COVID-19, in particular those with COVID toes,” said study author Esther E. Freeman, MD, PhD, director of Global Health Dermatology at Massachusetts General Hospital, in a press release. “[These] data adds to our knowledge about the long-term effects of COVID-19 in different organ systems. The skin is potentially a visible window into inflammation that could be going on in the body.”

Freeman added that clinicians are encouraged to take care of patients with COVID-19 by asking about and evaluating their skin symptoms.

“Health care providers can enter information into our registry to further our understanding of the dermatologic effects of COVID-19,” she said in a press release.

REFERENCE

Some COVID-19 “long haulers” experience lasting skin problems. EurekAlert! https://www.eurekalert.org/pub_releases/2020-10/mgh-sc102820.php. Published October 29, 2020. Accessed October 29, 2020.