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Analysis shows ‘long-hauler’ Covid-19 patients may experience prolonged skin symptoms

Photo: Raimond Spekking/Wikimedia Commons

Researchers at Massachusetts General Hospital conducted an analysis of the largest registry of Covid-19 patients with dermatologic symptoms and found a subset of patients referred to as ‘long-haulers’ who experienced prolonged symptoms (lasting more than 60 days) on their skin.

An abstract of the findings was presented at the 29th European Academy of Dermatology and Venereology Congress on Oct. 29, 2020.

Led by Dr. Esther Freeman, the principal investigator of the International COVID-19 Dermatology Registry and director of global health dermatology at Massachusetts General Hospital, researchers studied data from 990 Covid-19 cases across 39 countries which were input into the registry. The data showed an average duration of 12 days for all dermatological symptoms, with some lasting as long as 150 days.

The investigators found patients presented with a broad spectrum of dermatologic manifestations lasting different lengths of time, including hives (urticaria), lasting for an average of five days, and pernio or chilblains, known as ‘Covid toes’, lasting 15 days but sometimes as long as 130 to 150 days, and papulosquamous eruptions, persisting for 20 days.

According to researchers, the identification of this subset of patients with ‘Covid toes’ with symptoms lasting long after the acute phase of Covid-19 may have implications for understanding the prolonged inflammatory response in some patients after infection.

Skin symptoms vary by Covid-19 severity, the authors note. Additionally, some symptoms, such as retiform purpura, are associated with severe Covid-19, since 100% of these patients were hospitalized, while ‘Covid toes’ were associated with relatively mild disease, with only 16% hospitalized.

"Our registry identified a previously unreported subset of patients with longstanding skin symptoms from Covid-19,” said Dr. Freeman, in a press release. “We highlight patients with pernio/chilblains, also known as ‘Covid toes’, who have had symptoms for as long as 150 days.

“This data adds to our knowledge about how Covid-19 can affect multiple different organ systems, even after patients have recovered from their acute infection. The skin can provide a visual window into inflammation that may be going on elsewhere in the body."

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