Disseminated Herpes Zoster During COVID-19

Abstract

During the SARS-CoV-2 pandemic, a variety of dermatological conditions were reported by physicians. Given the context, these lesions have been labeled as secondary to SARS-CoV-2 infection. We report the case of a recurrence of herpes zoster in a patient hospitalized with an SARS-CoV-2 infection. The rash occurred on the 15th day of hospitalization while the patient was recovering from a severe form. Local swab showed the presence of varicella-zoster virus within the vesicles. Dermatological symptoms secondary to COVID-19 have been frequently described. This is the first case that demonstrates the recurrence of herpes zoster during a SARS-CoV-2 infection.

Case of atypical disseminated herpes zoster in a patient with COVID‐19: A diagnostic challenge in COVID era

“…7 A few cases of COVID-associated HZ were reported during the current pandemic which unlike to our case, none of them pose a diagnostic challenge. [8][9][10][11] The majority of these cases including ours belonged to the age group above 50 years. 9 However, most of those patients developed cutaneous lesions up to 1 week after the onset of COVID symptoms, [12][13][14] which was not congruent with the course of disease in our patient.…”

“…A few cases of COVID‐associated HZ were reported during the current pandemic which unlike to our case, none of them pose a diagnostic challenge. 8 , 9 , 10 , 11 …”

A Case Report of Varicella Zoster Meningitis as Co-Infection With Breakthrough COVID-19 in an Immunocompetent Patient

“…There are several reports that VZV infection can occur during SARS-CoV-2 infection. 1 3 4 VZV infection or reactivation is known to be associated with hyper-inflammatory status and immune dysregulation linked to COVID-19. 1 8 SARS-CoV-2 impairs the function of CD4+ T cells and promotes excessive activation and subsequent exhaustion of CD8+ T cells.…”

“…Emerging evidence suggests that varicella zoster virus (VZV) infection can occur after coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). 1 2 VZV co-infection with SARS-CoV-2 3 4 or after BNT162b2 mRNA SARS-CoV-2 vaccination has been reported recently. 5 6 7 Though the mechanism of VZV co-infection in COVID-19 is not fully understood, decreased cellular immunity and inflammation after SARS-CoV-2 infection is suggested as a possible cause of VZV infection.…”

Oral Herpes Zoster Infection Following COVID-19 Vaccination: A Report of Five Cases

“…A variety of dermatological signs and symptoms have been reported worldwide following COVID-19 infection. HZ is one of these dermatological signs [8,9]. Some patients had reactivation of VZV following recovery from symptomatic COVID-19 [10,11].…”