Clinical Cutaneous Features of Patients Infected With SARS-CoV-2 Hospitalized for Pneumonia: A Cross-sectional Study. (18th October 2020)

• Record Type: Journal Article
• Authors: Mascitti, Hélène; Bonsang, Benjamin; Dinh, Aurélien; Assan, Florence; Perronne, Véronique; Leblanc, Thibault; Duran, Clara; Bouchand, Frédérique; Matt, Morgan; Le Gal, Aurélie; N'guyen Van Thanh, Julia; Lanore, Aymeric; Jacob, Louis; Kiavue, Nicolas; Siméon, Soline; Bessis, Simon; de Truchis, Pierre; Landowski, Stéphanie; Davido, Benjamin; Moreau, Frédérique; Rameix-Welti, Marie-Anne; Gault, Elyanne; Gaillard, Jean-Louis; Roux, Anne-Laure; Sivadon-Tardy, Valérie; Salomon, Elsa; El Sayed, Faten; Carlier, Robert; Emile, Jean-François; Perronne, Christian; Bourgault-Villada, Isabelle;
• Is Part Of: Open forum infectious diseases. Volume 7:Number 11(2020)
• Publication Date: 2020-10-18
• Subjects: COVID-19 -- dermatology -- exanthema -- pandemics -- pneumonia; Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofaa394
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a current pandemic worldwide. This virus can reach all organs and disturbs the immune system, leading to a cytokine storm in severe forms. We aimed to report cutaneous features among coronavirus disease 2019 (COVID-19) hospitalized patients. Methods: We performed a cross-sectional study on 1 given day among all patients hospitalized in acute care for COVID-19 and included all patients with cutaneous features. Follow-up 48 hours later was obtained. Results: Among 59 adult patients hospitalized on the day of the study in an infectious diseases ward for SARS-CoV-2 infection who were confirmed by molecular assay and/or radiological findings (computed tomography scan), 40 were included. Several cutaneous manifestations were found: macular exanthema (80%), face edema (32%), livedo (13%), urticarial rash (8%), purpura (5%), oral lichenoid lesions (33%), and conjunctivitis (18%). Cutaneous biopsy was performed in 17 patients. Histological findings showed mast cell hyperplasia (100%), superficial perivascular infiltrate of lymphocytes (94%), and superficial edema (47%) consistent with capillary leak. Conclusions: Various dermatological signs can be encountered during COVID-19. A macular rash was the most frequent. All cutaneous features could be related to a vascular leak process. Abstract : This cross-sectional study showed that cutaneous features are various among hospitalized patients with COVID-19. Macular rash was the most frequent and could be predictive of worsening. They seem related to an immune system disturbance, leading to a vascular leak process.