Neha Deo, BS
Medical Student
Mayo Clinic Alix School of Medicine
Disclosure information not submitted.
Vikas Bansal, MPH, MBBS
Research Fellow
Mayo Clinic
Rochester, Minnesota
Disclosure information not submitted.
Thoyaja Koritala, MD
Physician
Mayo Clinic Health System in Mankato, United States
Disclosure information not submitted.
Marija Bogojevic, MD,
Resident Physician
Montefiore New Rochelle Hospital, Minnesota, United States
Disclosure information not submitted.
Romil Singh, MD
Resident
n/a
Rochester, Minnesota, United States
Disclosure information not submitted.
Mayank Sharma, MBBS
Research Fellow
n/a, Minnesota, United States
Disclosure information not submitted.
Simon Zec, MD (he/him/his)
Research Fellow, Pulmonary and Critical Care Medicine
Mayo Clinic
Rochester, Minnesota, United States
Disclosure information not submitted.
Vishakha Kumar, MD, MBA
Society of Critical Care Medicine
Mount Prospect, Illinois
Disclosure information not submitted.
Allan Walkey, MD (he/him/his)
Professor of Medicine
Boston University
Boston, Massachusetts, United States
Disclosure information not submitted.
Ognjen Gajic, MD
Professor
Mayo Clinic
Rochester, Minnesota, United States
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Rahul Kashyap, MD, MBA,
Medical Director Research
Wellspan Health-York Hospital
York, Pennsylvania
Disclosure information not submitted.
Juan Pablo Domecq Garces, MD
Assistant Professor of Medicine
Mayo Clinic College of Medicine
North Mankato, Minnesota, United States
Disclosure information not submitted.
Title: Dermatologic manifestations in patients with COVID-19: Results from the DISCOVERY VIRUS Registry
INTRODUCTION/HYPOTHESIS: As of July 2021, more than 4,000,000 deaths have been attributed to Coronavirus Disease 2019 (COVID-19) worldwide. Given the global burden of this pandemic, it is important to understand the presenting signs and its implications with the disease course. A growing number of literature shows that cutaneous manifestations of COVID-19 precede respiratory symptoms. Here, using the Viral Infection and Respiratory Illness Universal Study (VIRUS) registry, we are reporting dermatological manifestations in hospitalized patients with COVID-19, including their timing of presentation and clinical outcome.
Methods: The VIRUS registry is an international, observational, prospective database that collects and stores data for those who are hospitalized with laboratory confirmed SAR-CoV-2 infection. It involves 306 sites in 28 countries. We sent a survey to the sites that recorded patients with “rash” in the database. This survey had specific data elements to better capture the types of cutaneous manifestations, dermatologic co-morbidities, existing skin allergies, treatments and their outcomes. The survey was created specifically for this purpose using input from dermatologists and critical care physicians.
Results: 310 out of 64580 patients exhibited cutaneous manifestations. Among those, 52 patients with exanthems were included for subgroup analysis. Patients with skin manifestation were 12 years old (IQR 4.2-50.3) and 39.0% were female. 63.0% were 18 years old or younger. Skin manifestations related to COVID-19 varied in type. Overall, a majority of patients presented with macular erythema (11, 21.1%), maculopapular rash (8, 15.4%), and urticaria (5, 9.6%). Exanthems were mainly found on the trunk (29, 55.6%), extremities (26, 50%), and face (12, 23.1%). Oral antihistamines were provided to 2 (3.8%) patients and resulted in symptomatic improvement. Corticosteroids were given to 16 (34.6%) patients who presented with cutaneous symptoms. 41 (78.4%) of patients had complete resolution of symptoms.
Conclusions: Cutaneous manifestation in patients with COVID-19 are rarely reported but the clinical course is little understood. We found that exanthems are mainly reported in children and found on the trunk. The use of corticosteroids and antihistamines was associated with resolution of symptoms.