Characteristics of telogen effluvium in COVID-19 in western Iran (2020)

Objective While there are literature reporting increased incidence of hair loss in COVID‐19 patients, insufficient evidence exists on the topic to date. This review aims to identify the existing evidence and clinical characteristics of hair loss with COVID‐19 infection. Methods Following the PRISMA Extension for Scoping Reviews, MEDLINE and EMBASE were searched for all peer‐reviewed articles with relevant keywords including “Alopecia,” “Telogen Effluvium (TE),” and “COVID‐19” from their inception to November 20, 2021. Results A total of 26 articles, with 9 observational studies and 17 case reports or series (a total of 58 cases), were included. Most studies dealt with TE. There were no clear trends between COVID‐19 severity and the extent of hair loss. Analysis of the 58 cases also found similar results with most of the cases being female (82.8%), the median onset of hair loss of 2.0 months, and the median time to recovery of hair loss of 5.0 months with a resolution rate of 95%. Conclusion While this systematic review revealed uncertainty and a lack of strong evidence regarding the association of COVID‐19 and hair loss, hair loss in COVID‐19 may mainly include TE and be reversible in nature. Future studies are warranted to determine the detailed pathophysiology and risk factors of hair loss in COVID‐19, including possible roles of estrogen, progesterone, and pro‐inflammatory cytokines.

Section: Resultsmentioning

confidence: 99%

Characteristics of hair loss after COVID‐19: A systematic scoping review

Czech

Sugihara

Nishimura

2022

“…Additionally, 728 more cases of patients who developed TE after the diagnosis of COVID-19 have been described in Europe, the United States, and Asia [22][23][24][25][26][27][28][29][30][31] .…”

Section: Re Sultsmentioning

confidence: 99%

Hair and nail manifestations of COVID‐19

Tammaro

Adebanjo

Parisella

et al. 2022

Emerging literature evidence shows that the manifestations of the coronavirus disease 2019 (COVID‐19), which is the disease caused by SARS‐CoV‐2, encompass alterations of the pulmonary, cardiovascular, gastrointestinal, and neurological system. Moreover, hematologic and dermatologic manifestations have been documented. The aim of this review is to summarize the dermatologic manifestations of COVID‐19 involving the hair and nails in a narrative way. A total of 1136 patients have been reported to have de novo hair loss following COVID‐19. Notably, 958 patients experienced telogen effluvium (TE) (female/male ratio = 3,86:1), two female patients experienced anagen effluvium, and 176 people had alopecia areata (female/male ratio of 19:3). Ten patients were reported to have ungual changes following the infection with the novel coronavirus: The individuals affected were 6 women and 4 men. COVID‐19 can be associated with hair and ungual manifestations. This review summarizes the evidence regarding the hair and ungual manifestations of COVID‐19, which could be harnessed to better understand the clinical implications and pathophysiology of this disease that has been burdening society globally since December 2019.

“…In studies in the literature, the rate of female sex in patients with TE with a history of COVID-19 has been reported between 77.9% and 92.3% similar to our study. [5][6][7]9,10,13,15 This might be explained by the fact that female patients notice hair shedding more easily due to their hair length and need to consult a physician more frequently because of taking hair loss more seriously than men. 11 The use of vitamin supplements was significantly higher in the group with a history of COVID-19 in our study.…”

Section: Ta B L E 1 Clinical and Demographic Features Of The Patientsmentioning

confidence: 99%

Evaluation of patients with telogen effluvium during the pandemic: May the monocytes be responsible for post COVID‐19 telogen effluvium?

Yıldırım

Erbağcı

Öğüt

2022

Introduction: Telogen effluvium (TE) is one of the causes of non-scarring hair loss that occurred commonly 2-3 months after a triggering factor. It was reported that the incidence of TE increased during the COVID-19 (coronavirus disease 2019) pandemic.However, to date, there is no study evaluating the status of COVID-19 before the onset of hair loss in patients with TE. The aim of this study is to evaluate the patients with TE whether they had COVID-19 or not before the onset of their hair loss and to compare the demographic and clinical characteristics and laboratory parameters of those with and without a history of COVID-19. Method:We conducted an observational cohort study of TE patients. The diagnosis of TE depended on anamnesis and physical examination of the patients. Also, hair pull test was performed. Demographic data and the results of COVID-19 real-time polymerase chain reaction (RT-PCR) were recorded from the electronic medical records.Results: Totally, 181 patients with TE were included in the study. Sixty-four of patients (35.4%) had been diagnosed with COVID-19 before the hair loss started. The median duration of development of hair loss was 2 months (range 1-11 months, IQR 3) after COVID-19 diagnosis. In this group, 87.5% of patients (n = 56) had acute TE and 12.5% of patients (n = 8) had chronic TE. The rate of acute TE and the use of vitamin supplements were ignificantly higher (p < 0.001 and p = 0.027, respectively) and the monocyte count in peripheral blood was lower (p = 0.041) in the group diagnosed with COVID-19. Discussion and Conclusion:It was stated that monocytes and macrophages infected by SARS-CoV-2 can produce pro-inflammatory cytokines that play a crucial role in the development of COVID-19-related complications. Also, it was suggested that the number of monocytes tends to be lower in the late recovery stage. The lower monocyte count in patients with a history of COVID-19 in our study may be related to evaluating the patients in the late period of recovery and the migration of circulating monocytes to hair follicles. The history of COVID-19 must be questioned in patients with TE. It should be kept in mind that hair loss that develops after COVID-19 may be presented as chronic TE form too. The exact mechanisms of hair loss induced by COVID-19 are not fully explained; the roles of monocytes on the hair follicles may be one of the responsible mechanisms. How to cite this article: Koç Yıldırım S, Erbağcı E, Demirel Öğüt N. Evaluation of patients with telogen effluvium during the pandemic: May the monocytes be responsible for post COVID-19 telogen effluvium?