COVID‐19 and HHV8 first spotted together: an affair under electron microscopy

Background COVID‐19 is associated with several cutaneous manifestations, including chilbain‐like lesions, urticaria, erythema multiforme, and maculopapular lesions. Dermatoses may be directly linked to the viral infection or also represent a consequence of systemic therapies administrated for COVID‐19. A potential role of SARS‐CoV‐2 in triggering the reactivation of other viruses, such as HHV‐6, HHV‐7 and Epstein‐Barr virus has been hypothesized. Objective To better understand and hypothesize possible pathogenetic correlations of COVID‐19 with other dermatological conditions. Methods We report the case of an 83‐year‐old woman hospitalized in a nursing home for several years. On November 2020, the patient had been diagnosed with SARS‐CoV‐2 infection, with repeated positive swabs until January 2021. After a month, new‐onset asymptomatic cutaneous purplish macular lesions and violaceous patches occurred bilaterally on the feet. Results An incisional cutaneous biopsy and the histological examination of the plantar lesion revealed the diagnosis of Kaposi Sarcoma. Conclusion We report a unique case of new‐onset bilateral Kaposi's sarcoma following COVID‐19, speculating on a possible role of SARS‐CoV‐2 in the reactivation of human herpes virus‐8 (HHV‐8) infection.

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“…patient with previous history of KS. 4 Thus, to the best of our knowledge, this is the first case of new-onset KS after COVID-19 in literature.…”

Section: Discussionmentioning

confidence: 65%

“…We report a unique case of KS following SARS‐CoV‐2 infection. Only one case of SARS‐CoV‐2‐related KS has been reported so far in a patient with previous history of KS 4 . Thus, to the best of our knowledge, this is the first case of new‐onset KS after COVID‐19 in literature.…”

Section: Discussionmentioning

confidence: 70%

New‐onset cutaneous kaposi’s sarcoma following SARS‐CoV‐2 infection

Magri¹,

Giordano²,

Latini

et al. 2021

J of Cosmetic Dermatology

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“…[ 9 ]. Interestingly, a prior report highlighted the case of a patient with KS who developed a skin rash after acquiring COVID-19 infection, which suggests that the hyper-inflammatory state associated with COVID-19 may lead to proliferation of HHV8 and result in recurrence of KS [ 10 ]. Approach to treatment of COVID-19 in PLWH should be same as that of the general population with a few exceptions.…”

Section: Discussionmentioning

confidence: 99%

A case of acquired immunodeficiency syndrome-related Kaposi sarcoma in a patient with COVID-19 – A brief review of HIV-COVID Co-infection and its Therapeutic challenges!

Nasrullah

Patel

Din

et al. 2021

Respiratory Medicine Case Reports

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Barriers posed by the COVID-19 pandemic have led to reduced access to Human Immunodeficiency virus (HIV) care, leaving untreated patients at risk for various superimposed infections and malignancies such as Kaposi sarcoma (KS). We recently encountered a 37-year-old African-American male with a past medical history of HIV who tested positive for SARS-CoV-2 and was diagnosed with AIDS-related disseminated KS, representing the first reported case of COVID-19 infection with a newly diagnosed concomitant KS. The patient experienced multi-organ failure requiring tracheostomy, renal replacement therapy, and a prolonged intensive care unit (ICU) stay. Goals of care were changed to comfort measures and the patient passed away shortly afterwards. He was made comfort measures and passed away shortly afterwards. AIDS-related KS is a vascular tumor seen in association with Human Herpes Virus-8 (HHV-8). Management of limited AIDS-related KS typically includes combined antiretroviral therapy (ART) while multi-organ KS disease demands systemic chemotherapy. Immunosuppression should be avoided in patients with AIDS-related KS as it can lead to progression of KS. This recommendation is in conflict with the usual standard of care for patients with COVID-19 pneumonia, requiring clinical judgment and a customized approach based on the stage and severity of both the KS and the COVID-related disease. We briefly review HIV-COVID-19 coinfection, AIDS related KS and challenges associated with their management.

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“…According to our knowledge, only one case of cutaneous HHV-8-related KS after COVID-19 has been described so far [ 6 ]. A woman with previous history of KS experienced new skin relapse during COVID-19 (histological confirmation).…”

Section: Introductionmentioning

confidence: 99%

Disseminated Kaposi sarcoma following COVID-19 in a 61-year-old Albanian immunocompetent man: a case report and review of the literature

et al. 2021

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Background COVID-19 and its related anti-inflammatory treatment (steroids, immunomodulators) may induce the reactivation of latent bacterial, parasitic, and viral infections. According to our knowledge, no case of disseminated HHV-8-related Kaposi sarcoma (KS) after COVID-19 and its treatment has been described so far. Only one case of cutaneous KS concurrently with COVID-19 has been previously reported. Case presentation We describe a case of disseminated KS in a 61-year-old immunocompetent Albanian man after hospitalization for COVID-19. Methods for literature research We used PubMed as biomedical database for the literature research. We selected keyword combinations including “Kaposi sarcoma,” “HHV-8,” “immunocompetent,” “COVID-19,” “SARS-CoV-2,” and “steroids.” No time or language limitation was set. Titles and abstracts of selected articles were systematically screened. Articles were included in the examination if they were published under free access through the digital library of the University of Brescia (Italy), and provided full text. Articles were excluded if the topic was beyond the aim of our study. Finally, we selected 15 articles. Results We describe a case of KS in COVID-19 patient and postulate that Interleukin-6 (IL-6) activity and steroid-induced immunodeficiency may play a major role in KS emergence. No published case of disseminated KS following COVID-19 in otherwise healthy individuals was found through the systematic literature review, despite the high incidence of COVID-19 in areas with medium–high prevalence of HHV-8 infection. This observation might be explained by the role of individual genetic susceptibility factors. Conclusions SARS-CoV-2 infection and its treatment may lead to reactivation of several latent infections, including HHV-8 and its related clinical syndrome, Kaposi sarcoma.

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COVID‐19 and HHV8 first spotted together: an affair under electron microscopy

Cited by 10 publications

References 4 publications

New‐onset cutaneous kaposi’s sarcoma following SARS‐CoV‐2 infection

New‐onset cutaneous kaposi’s sarcoma following SARS‐CoV‐2 infection

A case of acquired immunodeficiency syndrome-related Kaposi sarcoma in a patient with COVID-19 – A brief review of HIV-COVID Co-infection and its Therapeutic challenges!

Disseminated Kaposi sarcoma following COVID-19 in a 61-year-old Albanian immunocompetent man: a case report and review of the literature

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