Cutaneous manifestations of COVID-19 in a tertiary COVID-19 referral hospital in the Philippines

Abstract

Background Reports on COVID-19 skin manifestations and associated clinical outcomes are limited. Like viral diseases, cutaneous findings may be present and can help in confirmation and prognostication among those suspected or diagnosed with COVID-19. Objective To determine COVID-19 cutaneous manifestations and their association with disease severity and course. Methods This study was conducted in a designated COVID-referral hospital from January 1 to March 31, 2021. Skin manifestations recorded from January 1 to February 17 were retrospectively gathered. Reports from February 18 to March 31 were prospectively collected using a dermatologic checklist which was incorporated in all official medical records. Results A total of 507 confirmed COVID-19 patients were included. COVID-19 skin signs were detected in 39 patients (7.7%). Morbilliform lesions were most common. Skin signs were significantly associated with severe or critical cases (OR 3.4; 95% CI 1.3 to 8.7) and mortality (RR 2.9; 95% CI 2.0 to 4.2). Limitation Underestimation of prevalence of COVID-19 skin signs due to exclusion of outpatient and discharged patients and the subjective assessment in the retrospective part. Conclusion Cutaneous signs were significantly associated with severe/critical COVID-19 as well as death among 507 hospitalized patients in a Philippine COVID referral hospital.

Skin Manifestations Among Patients Admitted with COVID-19: A Cross-Sectional Study at a University-Based Tertiary Hospital in Jordan

“…Like other studies, most of these patients were above the age of 50 years, which emphasizes the importance of age as a predictor for having a more severe COVID-19 infection, 19 skin findings were significantly associated with severe or critical cases. 20 In this cohort of patients with moderate-to-severe infection, around 7.5% had a cutaneous rash (5.2% skin and 2.3% oral thrush). The most common cutaneous manifestations seen in this group include reactive erythema, exanthema, vascular, and reactivation of pre-existing skin conditions.…”

Prevalence of cutaneous manifestations in COVID‐19: A meta‐analysis

“…The lowest mortality rate 0.02% (1/5933) was reported by Spain 22 . The mortality rate of 21.89% (111/507) reported by Philippines ranked first 23 . Furthermore, the mortality rates in the other five studies from low to high were as follows: less than 0.43% (54/12 599) in America, 24,25 1.01% (1/988) in India, 26 1.36% (15/1099) in China, 10 17.81% (251/1409) in Italy, 27 respectively.…”

“…21 22 The mortality rate of 21.89% (111/507) reported by Philippines ranked first. 23 Furthermore, the mortality rates in the other five studies from low to high were as follows:…”

Philippine COVID-19 Vaccination Through an Infodemiological Lens: A One-year Web-based Search Volume Analysis From 2020 to 2021

“…The keyword's rising and top related queries revolved around COVID-19 vaccine registration, side effects, alcohol, and efficacy (Table I). These signify a rising interest in COVID-19 vaccine registration starting in March 2021 during the start of COVID-19 vaccination in the Philippines (3). There was also a peak in interest in June 2021 that coincided with the Philippine government's measures to ease domestic travel restrictions and shorter quarantine periods for people who are vaccinated (4,5).…”

“…Philippine authorities have also claimed vaccine preference and disinformation have led to hesitations in COVID-19 vaccine registration (2). However, while authorities have used social modeling, including the real-time broadcast of public figures' vaccination and weekly information campaigns by the Department of Health (DOH) since the start of COVID-19 vaccination in March 2021, vaccine hesitancy and preference remained (2,3).…”