Cutaneous manifestations associated with anosmia, ageusia and enteritis in SARS-CoV-2 infection – A possible pattern? Observational study and review of the literature

Bîrluțiu, Victoria; Feiereisz, Alin Iulian; Oprinca, George-Călin; Dobritoiu, Simona Elena; Rotaru, Maria; Bîrluţiu, Rareş Mircea; Iancu, Gabriela Mariana

doi:10.1016/j.ijid.2021.04.058

Cited by 11 publications

(10 citation statements)

References 20 publications

(15 reference statements)

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“…COVID-Zehen, v. a. bei jüngeren und kaum symptomatischen Patienten, beschrieben, die als bläuliche, kissenartige Verdickungen über den kleinen Zehen-aber auch Fingergelenken imponieren und die einer Pernio bzw. Chilblain-Läsion sehr ähnlich sehen, häufig aber asymmetrisch und scharf begrenzt sind[62], wobei der lokale Nachweis von SARS-CoV-2 oft nicht gelingt[63].10.1.1 Pathogenetische Konzepte dermatologischer Symptome bei Post-/Long-COVID-19Histologisch finden sich z. T. Hinweise auf thromboembolische/ thrombotische Ereignisse in kleinen Hautgefäßen, denen wahrscheinlich viral-geladene Antigen-Antikörper-Immunkomplexe zugrunde liegen, z. T. perivaskuläre lymphozytäre Infiltrate und z. T. ein intradermales Ödem[60,[67][68][69][70] und im weiteren Verlauf eine fibrosierende Umwandlung des dermalen Gewebes[71]. ACE2 wird von epidermalen und follikulären Keratinozyten, dermalen Fibroblasten, vaskulären Endothelzellen in der Haut exprimiert[72] und die Expression korreliert mit Entzündungsparametern (natürliche Killerzellen, zytotoxische T-Zellen, B-Zellen)[73].…”

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S1-Leitlinie Post-COVID/Long-COVID

et al. 2021

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ZusammenfassungDie Deutsche Gesellschaft für Pneumologie hat die AWMFS1-Leitlinie Post-COVID/Long-COVID initiiert. In einem breiten interdisziplinären Ansatz wurde diese S1-Leitlinie basierend auf dem aktuellen Wissensstand gestaltet.Die klinische Empfehlung beschreibt die aktuellen Post-COVID/Long-COVID-Symptome, diagnostische Ansätze und Therapien.Neben der allgemeinen und konsentierten Einführung wurde ein fachspezifischer Zugang gewählt, der den aktuellen Wissensstand zusammenfasst.Die Leitlinie hat einen expilzit praktischen Anspruch und wird basierend auf dem aktuellen Wissenszugewinn vom Autorenteam stetig weiterentwickelt und adaptiert.

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S1-Leitlinie Post-COVID/Long-COVID

et al. 2021

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“…Study of the molecular mechanisms by which SARS-CoV-2 enters host cells has shed light on different receptor proteins, including ACE2 and TMPRSS2 [ 57 ]. Therefore, during the pandemic months, we focused on the expression of these receptors in the most disparate body areas, including the skin, considering that skin manifestations were being increasingly reported in SARS-CoV-2-affected, or previously positive, patients [ 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 ]. In a January 2021 paper, Xiaotong X. et al [ 47 ] conducted an elegant analysis using different molecular methods to study the expression of ACE2 in skin biopsy samples.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, in a paper published in June 2021, Birlutiu V. et al [ 88 ] studied 39 patients with SARS-CoV-2 who presented typical symptoms such as anosmia, ageusia, weakness and fatigue; in two cases, a skin biopsy was performed, which showed similar characteristics to other lesions described in the literature. The authors postulated a basic mechanism, mediated by ACE2, which could be common to cutaneous manifestations, anosmia, ageusia and enteritis developing during COVID-19.…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 and Skin: New Insights and Perspectives

Cazzato

Cascardi²,

Colagrande³

et al. 2022

Biomolecules

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The SARS-CoV-2 pandemic has disrupted global health systems and brought the entire globe to its knees. Although born as a disease of the respiratory system, COVID-19 can affect different parts of the body, including the skin. Reports of ongoing skin manifestations of COVID-19 have gradually multiplied, pushing researchers to investigate the etiopathogenic mechanisms underlying these phenomena in more depth. In an attempt to investigate the possible association between SARS-CoV-2, ACE2, TMPRSS2 and skin manifestations, we performed immunohistochemical investigations of the ACE2 receptor and TMPRSS2 in nine skin samples from SARS-CoV-2-positive patients compared to a cohort of healthy controls. Furthermore, after consulting public databases regarding ACE2 mRNA expression in various cell populations resident in the skin, we conducted a literature review aimed at outlining the current state of this topic. We did not find statistically different immuno-expression of ACE2 and TMPRSS2 between the group of SARS-CoV-2-positive patients (nine skin biopsies) and the control group. Regarding ACE2, major immunolabeling was present in the epidermal keratinocytes and, rarely, in the fibroblasts and in the adenomeres of the eccrine sweat glands. Regarding the immune expression of TMPRSS2, we found no significant differences between the two groups, with a weak immune staining only in some skin cytotypes. From the review of the literature, we isolated 35 relevant articles according to the inclusion criteria adopted. ACE2 appears to be a target of SARS-CoV-2, although, other receptor molecules may potentially be implicated, such as TMPRSS2. Future studies with large cases and different molecular investigative methods are needed to further elucidate the mechanisms underlying the skin manifestations of SARS-CoV-2.

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“…[3] Also, the neurotropic properties and the cutaneous manifestations of SARS-CoV-2 are increasingly identified. [4–7]…”

Section: Introductionmentioning

confidence: 99%

Our experience with 80 cases of SARS-CoV-2-Clostridioides difficile co-infection: An observational study

et al. 2022

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Beside the changes in the gut microbiota in context of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the increased use of high-risk broad-spectrum antibiotics during the actual pandemic raises concerns about a possible increase of Clostridioides difficile infections (CDIs). We retrospectively analyzed 80 consecutive patients, with SARS-CoV-2 pneumonia and CDI. The mean length of hospitalization was 19.63 days. The mean time of the onset of the digestive symptoms related to CDI was 5.16 days. Patients with an onset of the digestive symptoms from hospital admission have a significantly lower median length in hospital stay. The recovered patients present a statistically significant decreased median age. coronavirus disease 2019 (COVID-19) cured patients present CDI symptoms much earlier than the deceased patients, when comparing the median days before the occurrence of any digestive symptoms regarding CDI. Among the patients that prior to their hospitalization for COVID-19 were exposed to antibiotics, 54.7% presented CDI digestive symptoms during their hospitalization and 65.6% had a severe or critical COVID-19 form. Although the incidence of CDI in the pandemic is lower compared to the period before the pandemic, the severity of cases and the death rate increased. In the actual setting clinicians need to be aware of possible CDI and SARS-CoV-2 co-infection.

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Cutaneous manifestations associated with anosmia, ageusia and enteritis in SARS-CoV-2 infection – A possible pattern? Observational study and review of the literature

Cited by 11 publications

References 20 publications

S1-Leitlinie Post-COVID/Long-COVID

S1-Leitlinie Post-COVID/Long-COVID

SARS-CoV-2 and Skin: New Insights and Perspectives

Our experience with 80 cases of SARS-CoV-2-Clostridioides difficile co-infection: An observational study

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