Chilblains outbreak during COVID-19 pandemic: A Type-I interferonopathy?
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ABSTRACT:
SUBMITTER: Mensa-Vilaro A
PROVIDER: S-EPMC9874765 | biostudies-literature | 2022 Oct
REPOSITORIES: biostudies-literature
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Chilblains outbreak during COVID-19 pandemic: A Type-I interferonopathy?
Mensa-Vilaró Anna A Vicente Asunción A Español-Rego Marta M Antón Jordi J Fabregat Virginia V Fortuny Claudia C González Europa Azucena EA Fumadó Victoria V González-Roca Eva E Jou Cristina C Plaza Susana S Mosquera Juan Manuel JM Yagüe Jordi J Prat Carolina C Pascal Mariona M Juan Manel M Arostegui Juan I JI Baselga Eulalia E Alsina Laia L
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology 20221001 10
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Project description:ImportanceBeginning in March 2020, case reports and case series linked the COVID-19 pandemic with an increased occurrence of chilblains, but this association has not been evaluated in an epidemiologic study.ObjectiveTo assess whether a correlation exists between COVID-19 incidence and chilblains incidence.Design, setting, and participantsA retrospective cohort study was conducted within the Kaiser Permanente Northern California system from January 1, 2016, to December 31, 2020; health plan members of all ages were included.ExposureCOVID-19 incidence in 207 location-months, representing 23 geographic locations in northern California across 9 months.Main outcome and measuresChilblains incidence was the main outcome. The association of chilblains incidence with COVID-19 incidence across the 207 location-months was measured using the Spearman rank correlation coefficient.ResultsOf 780 patients with chilblains reported during the pandemic, 464 were female (59.5%); mean (SD) age was 36.8 (21.8) years. COVID-19 incidence was correlated with chilblains incidence at 207 location-months (Spearman coefficient 0.18; P = .01). However, only 17 of 456 (3.7%) patients with chilblains tested during the pandemic were positive for SARS-CoV-2, and only 9 of 456 (2.0%) were positive for SARS-CoV-2 within 6 weeks of the chilblains diagnosis. Test results of 1 of 97 (1.0%) patients were positive for SARS-CoV-2 IgG antibodies. Latinx patients were disproportionately affected by COVID-19 but not by chilblains.Conclusions and relevanceThis cohort study found that in northern California, the incidence of chilblains increased during the pandemic but was correlated weakly with the incidence of COVID-19 across 207 location-months. These findings may have resulted from a causal role of COVID-19, increased care-seeking by patients with chilblains during the pandemic, or changes in behavior during shelter in place.
| S-EPMC8223123 | biostudies-literature
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| S-EPMC7722689 | biostudies-literature
Project description:ImportanceDuring the coronavirus disease 2019 (COVID-19) pandemic, several cases of chilblains have been reported.ObjectiveTo determine if chilblains are associated with COVID-19.Design, setting, and participantsThis monocentric case series was conducted at the Department of Dermatology at Cliniques universitaires Saint-Luc, a tertiary care hospital in Brussels, Belgium, between April 10 and April 17, 2020. We evaluated a total of 31 referred patients who had recently developed chilblains.Main outcomes and measuresReal-time reverse transcriptase-polymerase chain reaction (RT-PCR) was used to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA on nasopharyngeal swabs for all patients and in skin biopsy specimens for 22 patients. Blood samples from all patients were tested for specific anti-SARS-CoV-2 immunoglobulin (Ig) M and IgG antibodies. All patients had extended blood analyses. Histologic (22 patients) and immunofluorescence examinations (15 patients) were performed on the skin biopsy specimens.ResultsThe 31 patients were generally in good health; most were teenagers or young adults, and 19 were women. Histopathologic analysis of skin biopsy specimens (22 patients) confirmed the diagnosis of chilblains and showed occasional lymphocytic or microthrombotic phenomena. Immunofluorescence analyses showed vasculitis of small-diameter vessels in 7 patients. In all patients, SARS-CoV-2 RNA remained undetected by RT-PCR on nasopharyngeal swabs and in biopsy samples of the skin lesions. The IgM and IgG antibody titers were negative for SARS-CoV-2 in all patients (<1.0 arbitrary unit/mL). No significant abnormalities in blood test results were suggestive of systemic disease. Antinuclear antibody titers were low in 7 patients and higher in 1 patient.Conclusions and relevanceChilblains appeared not to be directly associated with COVID-19 in this case series. Lifestyle changes associated with community containment and lockdown measures are a possible explanation for these lesions.
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| S-BSST1055 | biostudies-other
Project description:To understand and analyse the global impact of COVID-19 on outpatient services, inpatient care, elective surgery, and perioperative colorectal cancer care, a DElayed COloRectal cancer surgery (DECOR-19) survey was conducted in collaboration with numerous international colorectal societies with the objective of obtaining several learning points from the impact of the COVID-19 outbreak on our colorectal cancer patients which will assist us in the ongoing management of our colorectal cancer patients and to provide us safe oncological pathways for future outbreaks.
| 2346925 | ecrin-mdr-crc
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| S-EPMC7198162 | biostudies-literature
Project description:BackgroundAcral lesions, mainly chilblains, are the most frequently reported cutaneous lesions associated with COVID-19. In more than 80% of patients tested, nasopharyngeal swabs were negative on reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2 when performed, and serology was generally not performed.MethodsA national survey was launched on 30 March 2020 by the French Society of Dermatology asking physicians to report cases of skin manifestations in patients with suspected or confirmed COVID-19 by using a standardized questionnaire. We report the results for acral manifestations.ResultsWe collected 311 cases of acral manifestations [58.5% women, median age 25.7 years (range 18-39)]. The most frequent clinical presentation (65%) was typical chilblains. In total, 93 cases (30%) showed clinical suspicion of COVID-19, 67 (22%) had only less specific infectious symptoms and 151 (49%) had no clinical signs preceding or during the course of acral lesions. Histology of skin biopsies was consistent with chilblains. Overall, 12 patients showed significant immunological abnormalities. Of the 150 (48%) patients who were tested, 10 patients were positive. Seven of 121 (6%) RT-PCR-tested patients were positive for SARS-CoV-2, and five of 75 (7%) serology-tested patients had IgG anti-SARS-CoV-2. Tested/untested patients or those with/without confirmed COVID-19 did not differ in age, sex, history or acral lesion clinical characteristics.ConclusionsThe results of this survey do not rule out that SARS-CoV-2 could be directly responsible for some cases of chilblains, but we found no evidence of SARS-CoV-2 infection in the large majority of patients with acral lesions during the COVID-19 lockdown period in France. What is already known about this topic? About 1000 cases of acral lesions, mainly chilblains, were reported during the COVID-19 outbreak. Chilblains were reported to occur in young people within 2 weeks of infectious signs, which were mild when present. Most cases did not have COVID-19 confirmed by reverse transcription polymerase chain reaction (RT-PCR), and few serology results were available. What does this study add? Among 311 patients with acral lesions, mainly chilblains, during the COVID-19 lockdown period in France, the majority of patients tested had no evidence of SARS-CoV-2 infection. Overall, 70 of 75 patients were seronegative for SARS-Cov-2 serology and 114 of 121 patients were negative for SARS-CoV-2 RT-PCR.
| S-EPMC7361395 | biostudies-literature
Project description:BackgroundDuring and post COVID-19 pandemic outbreak, it is essential for safeguarding this viral infection control and prevention in pediatric dental practices. The role of parents and pediatric dentist and their dental team requires specific guidance to deal with dental problems of children in the dental operatory during and post-pandemic outbreak of COVID-19 disease.PurposeTo report dentistry for children during and post COVID-19 pandemic outbreak.ConclusionsThe present review highlights the clinical features, possible modes of transmission of COVID-19 in dental operatory, preventive strategies, emergencies that pose a significant challenge, and treatment strategies for dealing with children and parents during and post COVID-19 pandemic. Absolute measures for children during their visit to dental operatory, quality control for pediatric dental clinics, and additional preventive measures associated with examinations and management of dental problems in children have been covered in this insight.
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