A surge in the incidence of telogen effluvium in minority predominant communities heavily impacted by COVID-19

Cline, Abigail; Kazemi, Abrahem; Moy, Janet; Safai, Bijan; Marmon, Shoshana

doi:10.1016/j.jaad.2020.11.032

Cited by 15 publications

(31 citation statements)

References 2 publications

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“…The current study is the first prospective cohort study examining the prevalence of TE following SARS-CoV-2 infection. Previous short reports on a limited number of patients showed an increase in the incidence of post-SARS-CoV-2 TE [ 20 ], with particular reference to some ethnic groups [ 20 ]. We report a higher incidence of TE in patients after SARS-CoV-2, with about one-third of them presenting with this condition.…”

Section: Discussionmentioning

confidence: 99%

Post-SARS-CoV-2 Acute Telogen Effluvium: An Expected Complication

Monari

Gualdi

Bettoni³

et al. 2022

JCM

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Post-SARS-CoV-2 telogen effluvium has been described in case reports of COVID-19 patients. We evaluated the prevalence of post-SARS-CoV-2 telogen effluvium in patients from a single medical center, exploring any causal links with the infection. Our hospital-based, cross-sectional study was conducted with patient participants discharged with a diagnosis of SARS-CoV-2 pneumonia from 1 March to 4 April 2020. All patients were evaluated by the same senior dermatologist; a clinical/dermatoscopic evaluation was performed. Alopecia was assessed in 31.3% of patients, with a significant difference in sex (females 73%, males 26.7%). The average time detected from the onset of the first symptoms to alopecia was 68.43 days. Overall, there were no significant associations between alopecia and COVID-19-related features (length of hospitalization, virologic positivity, or duration of fever), treatment characteristics, or laboratory findings. In this paper, we report that post-infection acute telogen effluvium occurs in a significant number of COVID-19 patients. The burden of this condition may impair the quality of life, with a significant impact on individuals.

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Section: Discussionmentioning

confidence: 99%

Post-SARS-CoV-2 Acute Telogen Effluvium: An Expected Complication

Monari

Gualdi

Bettoni³

et al. 2022

JCM

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“… 5 Likewise, Cline et al showed an increase in the incidence of TE from 0.5% to 2.3%, nearly 3–4 months after COVID‐19 became a pandemic. 4 These two studies determined the incidence of TE in all hospital admissions but not in patients with a history of COVID‐19. In a recent study of 128 post COVID‐19 patients who presented to hair clinics with hair loss and/or scalp complaints, TE was observed in 66.3%.…”

Section: Discussionmentioning

confidence: 99%

“…Compared to the incidence of TE which has been found to be 2.17% and 2.3% during the pandemic period, the TE frequency of 27.9% in post‐COVID‐19 cases in our study suggests that COVID‐19 is an important trigger for the development of TE. 4 , 5 …”

Section: Discussionmentioning

confidence: 99%

“… 2 , 3 The incidence of TE in New York City has been shown to increase by more than 400%, approximately 3–4 months after the COVID‐19 was declared a pandemic. 4 However, to date, no studies have been conducted on the incidence of TE in the patients who have recovered from the COVID‐19. Besides, the relationship between the severity of COVID‐19 and the development of TE is unknown.…”

Section: Introductionmentioning

confidence: 99%

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COVID‐19 induced telogen effluvium

Aksoy

Yıldırım

Ergen

et al. 2021

Dermatologic Therapy

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COVID‐19 is a febrile, infectious illness that has previously been associated with telogen effluvium (TE). However, to date, no study has been conducted to determine the incidence of TE in those who have had COVID‐19. To assess the frequency of TE in post‐COVID‐19 patients and the correlation between the development of TE and the severity of COVID‐19, to understand whether emotional stress or medications are responsible for the development of TE. Totally 204 patients with a history of SARS‐CoV‐2 infection in the last 3 months were included in the study. The diagnosis of TE was made by history of excessive hair shedding, hair pull test, diffuse or bitemporal thinning, and absence of anisotrichosis in trichoscopy. Patients who did not have any TE cause other than COVID‐19 and whose hair loss started after COVID‐19 were considered as “COVID‐19 associated TE (CATE).” We found TE in 75 (36.7%) cases and androgenetic alopecia (AGA) in 85 (41.7%) cases. CATE was present in 27.9% of cases and developed on average 53.76 (± 23.772) days after COVID‐19 real‐time reverse transcription polymerase chain reaction (RT‐PCR) positivity. The proportion of patients with CATE was numerically higher in hospitalized patients compared to outpatients (31.7% vs. 24.3%; p = 0.238); and significantly higher in women compared to men (42.3% vs. 6.2%; p < 0.001), in patients with hypertension compared to those without hypertension (40.4% vs. 23.1%; p = 0.014), and in patients who had respiratory symptoms compared to those who had not (31.7% vs. 14.0%; p = 0.021). The patients with and without CATE were similar in terms of stress level and usage of COVID‐19 medications. Patients with AGA had a higher rate of hospitalization (69.4% vs. 35.3%; p < 0.001) and a higher incidence of fever (69.4% vs. 54.6%; p = 0.033) during COVID‐19, compared to those without. TE developed in approximately one‐quarter of people who have had COVID‐19, and our study is the first to detect it. The time to onset of CATE, which was 7–8 weeks after the SARS‐CoV‐2 RT‐PCR positivity, was not much different from post‐infectious TE. Patients with severe COVID‐19 seem to be more prone to develop TE. The presence of AGA is associated with a more severe COVID‐19. During the pandemic, clinicians should consider a previous SARS‐CoV‐2 infection in patients presenting with hair loss.

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“…7 Recently, alopecia areata and androgenetic alopecia were shown to be associated with COVID-19; however, acute telogen effluvium (TE) appears to be the most common trichologic disease in patients with COVID-19. [8][9][10][11][12][13][14][15][16][17] Trichodynia (TR) is a common accompanying symptom of TE, 18,19 but to date, the literature has been silent on its occurrence with respect to COVID-19. For this reason, we decided to collect data, using a multicenter survey, of all patients referred to our hair clinics for TE with or without TR with a history of COVID-19 infection and describe their characteristics.…”

Section: Introductionmentioning

confidence: 99%

Trichodynia and telogen effluvium in COVID-19 patients: Results of an international expert opinion survey on diagnosis and management

Starace

Iorizzo²,

Sechi

et al. 2021

JAAD International

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Background Cutaneous manifestations of COVID-19 may be useful disease markers and prognostic indicators. Recently, post-infectious telogen effluvium and trichodynia have also been reported. Objective To evaluate the presence of trichodynia and telogen effluvium in patients with COVID-19 and describe their characteristics in relation to other signs and symptoms of the disease. Methods Patients with a history of COVID-19 presenting to the clinics of a group of hair experts because of telogen effluvium and/or scalp symptoms, were questioned with regards about their hair signs and symptoms in relation to the severity of COVID-19 and associated symptoms. Results Data from 128 patients were collected. Telogen effluvium was observed in 66.3% of patients and trichodynia in 58.4%. Trichodynia was associated to telogen effluvium in 42.4% of cases and was associated to anosmia and ageusia in 66.1% and 44.1% of cases, respectively. In the majority of patients (62.5%), hair signs and symptoms started within the first month post-COVID-19 diagnosis and in 47.8% of patients after 12 weeks or more. Limitations Recruitment of patient in specialized hair clinics, lack of a control group, and lack of recording of patient comorbidities. Conclusion The severity of the post-viral telogen effluvium observed in patients with a history of COVID-19 infection is influenced by COVID-19 severity. We identified an early onset (<4 weeks) and a late onset (>12 weeks) telogen effluvium.

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A surge in the incidence of telogen effluvium in minority predominant communities heavily impacted by COVID-19

Cited by 15 publications

References 2 publications

Post-SARS-CoV-2 Acute Telogen Effluvium: An Expected Complication

Post-SARS-CoV-2 Acute Telogen Effluvium: An Expected Complication

COVID‐19 induced telogen effluvium

Trichodynia and telogen effluvium in COVID-19 patients: Results of an international expert opinion survey on diagnosis and management

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