Clinicopathologic correlations of COVID-19–related cutaneous manifestations with special emphasis on histopathologic patterns

Rongioletti, Franco; Ferreli, Caterina; Sena, Paolo; Caputo, Valentina; Atzori, Laura

doi:10.1016/j.clindermatol.2020.12.004

Cited by 38 publications

(97 citation statements)

References 83 publications

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“…A similar, annular rash has been previously described in a patient with MIS-A and heart failure [ 33 ]. Histopathological examinations of skin lesions in children have shown perivascular inflammation with the infiltration of lymphocytes [ 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Multisystem Inflammatory Syndrome Associated with SARS-CoV-2 Infection in an Adult: A Case Report from the Maldives

et al. 2021

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The multisystem inflammatory syndrome in adults (MIS-A) is a novel syndrome observed during COVID-19 outbreaks. This hyper-inflammatory syndrome is seen predominantly in children and adolescents. The case of an adult from the Maldives who had asymptomatic SARS-CoV-2 infection three weeks before presenting to the hospital with fever, rash, and shock is presented. De-identified clinical data were retrospectively collected to summarize the clinical progression and treatment during hospitalization and the six-month follow-up. SARS-CoV-2 infection was confirmed by RT-PCR. Other laboratory findings included anemia (hemoglobin: 9.8 g/dL), leukocytosis (leukocytes: 20,900/µL), neutrophilia (neutrophils: 18,580/µL) and lymphopenia (lymphocytes: 5067/µL), and elevated inflammatory markers, including C-reactive protein (34.8 mg/dL) and ferritin (2716.0 ng/dL). The electrocardiogram had low-voltage complexes, and the echocardiogram showed hypokinesia, ventricular dysfunction, and a pericardial effusion suggestive of myocardial dysfunction compromising hemodynamics and causing circulatory shock. These findings fulfilled the diagnostic criteria of MIS-A. The case was managed in the intensive care unit and required non-invasive positive pressure ventilation, inotropes, and steroids. With the new surges of COVID-19 cases, more cases of MIS-A that require the management of organ failure and long-term follow-up to recovery are anticipated. Clinicians should therefore be vigilant in identifying cases of MIS-A during the pandemic.

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Section: Discussionmentioning

confidence: 99%

Multisystem Inflammatory Syndrome Associated with SARS-CoV-2 Infection in an Adult: A Case Report from the Maldives

et al. 2021

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“…In the literature, there are few articles relating to skin biopsies on which such investigations have been carried out. In a recent review, Rongioletti et al [10] presented polymorphic aspects that can be observed on the skin of SARS-CoV-2 positive subjects. In particular, the authors investigate the clinical evidence that patients who develop Pseudochilblain lesions tend to have a better disease course, compared to patients with acro-ischemic/livedoid necrotic lesions, who tend to have a worse clinical outcome related to a state of impairment of the coagulation system.…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 and Skin: The Pathologist’s Point of View

et al. 2021

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The SARS-CoV-2 pandemic has dramatically changed our lives and habits. In just a few months, the most advanced and efficient health systems in the world have been overwhelmed by an infectious disease that has caused 3.26 million deaths and more than 156 million cases worldwide. Although the lung is the most frequently affected organ, the skin has also resulted in being a target body district, so much so as to suggest it may be a real “sentinel” of COVID-19 disease. Here we present 17 cases of skin manifestations studied and analyzed in recent months in our Department; immunohistochemical investigations were carried out on samples for the S1 spike-protein of SARS-CoV-2, as well as electron microscopy investigations showing evidence of virions within the constituent cells of the eccrine sweat glands and the endothelium of small blood vessels. Finally, we conduct a brief review of the COVID-related skin manifestations, confirmed by immunohistochemistry and/or electron microscopy, described in the literature.

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“…Aunque no se ha comprobado, se cree que el SARS-CoV-2 ocasiona activación de basófilos y mastocitos provocando urticaria. 34 Además, el folículo piloso responde a la infección y eventos estresantes con efluvio anágeno distrófico o efluvio telógeno, dependiendo de su intensidad, causando alope-cia que se presenta tres meses después de la infección con una duración aproximada de seis meses. 35,36…”

Section: Dermatológicounclassified

Efectos a largo plazo de la COVID-19: una revisión de la literatura

Bautista¹,

Martínez²,

Vilchis³

et al. 2021

Acta Médica Grupo Ángeles

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La COVID-19 tiene un amplio espectro de manifestaciones clínicas durante su curso y se han encontrado al menos 55 efectos a largo plazo que incluyen signos, síntomas y parámetros clínicos. Las etapas clínicas de la enfermedad se dividen en la fase aguda, fase postaguda y síndrome post-COVID-19. Estas fases se caracterizan por el desarrollo de signos y síntomas desde el inicio hasta cuatro semanas, entre cuatro a 12 semanas y más allá de 12 semanas, respectivamente. La prevalencia de signos y síntomas varía desde 35% hasta 94%; en la mayoría de los estudios (80%) predominan la fatiga, tos y disnea. Los potenciales mecanismos fisiopatológicos que explican el desarrollo de los síntomas incluyen la persistencia viral, alteraciones inmunológicas e inflamación, secuelas esperadas de una enfermedad crítica y cambios fisiopatológicos específicos de la enfermedad aguda en cada sistema. Hasta el momento, se desconoce el espectro completo del síndrome post-COVID; a pesar de haber identificado muchos de sus componentes clínicos aún faltan datos para reconocer el tiempo exacto de duración.

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Clinicopathologic correlations of COVID-19–related cutaneous manifestations with special emphasis on histopathologic patterns

Cited by 38 publications

References 83 publications

Multisystem Inflammatory Syndrome Associated with SARS-CoV-2 Infection in an Adult: A Case Report from the Maldives

Multisystem Inflammatory Syndrome Associated with SARS-CoV-2 Infection in an Adult: A Case Report from the Maldives

SARS-CoV-2 and Skin: The Pathologist’s Point of View

Efectos a largo plazo de la COVID-19: una revisión de la literatura

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