Inflammatory Skin Lesions in Three SARS-CoV-2 Swab-Negative Adolescents: A Possible COVID-19 Sneaky Manifestation?

Ingravallo, Giuseppe; Mazzotta, Francesco; Resta, Leonardo; Sablone, Sara; Cazzato, Gerardo; Cimmino, Antonietta; Rossi, Roberta; Colagrande, Anna; Ferrante, Beniamino; Troccoli, T.; Bonifazi, E.

doi:10.3390/pediatric13020025

Cited by 8 publications

(13 citation statements)

References 21 publications

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“…Andina et al [14] also described a case of a one-month-old baby girl with reticulated plantar purpura, negative to the molecular swab, but positive to IHC for SARS-CoV-2. We also, in another very recent work [15], described three cases of molecular test negative pediatric patients whose skin biopsies showed histological characteristics similar to those described in this new study, in the second group, who had tested positive for IHC for SARS-CoV-2.…”

Section: Discussionsupporting

confidence: 73%

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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Section: Discussionsupporting

confidence: 73%

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

et al. 2021

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“…More than a year and a half after its inception, the severe acute respiratory syndromecoronavirus 2 (SARS-CoV-2) pandemic continues to affect the entire globe, posing new challenges and new questions, as important pathogenic mechanisms go on being discovered [1,2]. It has now been demonstrated that SARS-CoV-2 can affect different organs, featuring different manifestations and clinical pictures [3][4][5][6]. Surely, the fundamental relationship between pregnancy and SARS-CoV-2 was partially studied at the start of the pandemic, but it began to be more thoroughly investigated as new evidence came to the fore [7].…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2, Placental Histopathology, Gravity of Infection and Immunopathology: Is There an Association?

Resta

Vimercati

Cazzato

et al. 2022

Viruses

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(1) Background: As the pandemic months progress, more and more evidence shows that the placenta acts as a “barrier” to SARS-CoV-2, although rare cases of vertical transmission have been described. (2) Methods: In an attempt to investigate whether the symptoms’ severity was related to different placental histological characteristics and the immune microenvironment, we subdivided 29 placentas from 29 mothers positive for SARS-CoV-2 into two groups, depending on the symptomatology (moderate/severe vs. asymptomatic/mild), performing immunohistochemical investigations for CD4 + and CD8 + T lymphocytes, as well as for CD68 + macrophage. We also evaluated the immuno-expression of the ACE2 receptor at the placental level. These two groups were compared to a control group of 28 placentas from 28 SARS-CoV-2-negative healthy mothers. (3) Results: The symptoms (likely to be related to viremia) were statistically significantly correlated (p < 0.05) with histopathological changes, such as maternal malperfusion, decidual arteriopathy, blood vessel thrombus of fetal relevance. Furthermore, the immuno-expression of ACE2 was significantly lower in SARS-CoV-2-positive groups vs. control group (p = 0.001). (4) Conclusions: There is still much to study and discover regarding the relationship between SARS-CoV-2 and histological changes in placentas and how the latter might contribute to various neonatal clinical outcomes, such as prematurity.

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“…Regarding skin involvement, reports of different eruption patterns became very frequent and numerous, both in the adult and pediatric population, first in China and then gradually throughout the globe [ 14 , 15 , 16 ]. Among the different cutaneous manifestations of COVID-19, erythematous rashes [ 17 , 18 , 19 , 20 , 21 , 22 , 23 ], pseudo-chilblains [ 24 , 25 , 26 ], acro-ischemia and livedoid lesions [ 27 , 28 , 29 , 30 , 31 , 32 ] or other cutaneous manifestations resembling pityriasis rosea, erythema elevatum diutinum, erythema multiforme and Grover disease have been reported [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ].…”

Section: Introductionmentioning

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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Inflammatory Skin Lesions in Three SARS-CoV-2 Swab-Negative Adolescents: A Possible COVID-19 Sneaky Manifestation?

Cited by 8 publications

References 21 publications

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

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

SARS-CoV-2, Placental Histopathology, Gravity of Infection and Immunopathology: Is There an Association?

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

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