New onset of alopecia areata in a patient with SARS‐CoV‐2 infection: Possible pathogenetic correlations?

Rossi, Alfredo; Magri, Francesca; Michelini, Simone; Sernicola, Alvise; Mellai, Marta; Caro, Gemma; Fraia, Marco Di; Chello, Camilla; Fortuna, Maria Caterina; Grieco, Teresa

doi:10.1111/jocd.14080

Cited by 36 publications

(48 citation statements)

References 6 publications

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“…Our results imply that the diagnosis of COVID-19 was not significantly associated with the development of AA even after appropriately adjusting for covariates. Notwithstanding study in Turkey showed an increase in the percentage of patients with AA after the COVID-19 pandemic compared before the pandemic (6) and several case reports suggested the possibility of an association between COVID-19 diagnosis and development of AA (3,5,8), our study based on South Korea resulted in that COVID-19 diagnosis not having significant association with new onset of AA. This inconsistency could have arisen because of the study design; our study subject being national representative, while previous studies based on a small sample size that could not perform adequate statistical analysis; our study having an adequate control group to ensure internal validity.…”

Section: Discussioncontrasting

confidence: 53%

“…A South Korea-based previous study that examined the effect of underlying skin disease on COVID-19 susceptibility and mortality also detected no association between skin disease and COVID-19 (32). However, previous studies were mostly based on western society (3)(4)(5)(7)(8)(9), where the racial composition is different from South Korea. Also, the country where the research is based could derive different results.…”

Section: Discussionmentioning

confidence: 97%

“…the way that COVID-19 itself affects autoimmune pathogenesis of AA (3)(4)(5) or that psychological stress caused by restriction policy against COVID-19 burdens AA (3)(4)(5)(6)(7)(8). However, there is a study that mild to moderate COVID-19 is not associated with worsening AA (9).…”

Section: Introductionmentioning

confidence: 99%

“…However, there is a study that mild to moderate COVID-19 is not associated with worsening AA (9). This inconsistency might result from limitations of extant literature: relying on cross-sectional studies with restricted study subjects without the control group (4,6,(8)(9)(10), based on a small sample size that is not national representative (3)(4)(5)(6)(7)(8)(9). Furthermore, the study based on South Korea lacks even though South Korea having about 152,000 survivors (1).…”

Section: Introductionmentioning

confidence: 99%

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Lack of Evidence of COVID-19 Being a Risk Factor of Alopecia Areata: Results of a National Cohort Study in South Korea

et al. 2021

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Background: Concerns about alopecia areata (AA) in coronavirus disease 2019 (COVID-19) patients have emerged among dermatologists. However, most of the extant kinds of literature have limited implications by relying on cross-sectional studies with restricted study subjects without the control group.Objective: Our study aims to investigate the risk of developing AA among COVID-19 patients in South Korea using national representative data.Methods: We used the National Health Insurance Service COVID-19 cohort database, comprising COVID-19 patients and the control group, all of whom were diagnosed from January 1, 2020, to June 4, 2020. Patients were defined as individuals who were confirmed as COVID-19 positive, regardless of disease severity. Controls were defined as those who were confirmed as COVID-19 negatives. People with a history of AA during the period 2015–2019 were excluded. The primary endpoint was a new diagnosis of AA (ICD-10-Code: L63). The adjusted incidence rate ratio (IRR) of developing AA was estimated using a log-link Poisson regression model based on incidence density. The model adjusted for (1) age and sex and (2) demographic variables (age, sex, place of residence, and income level).Results: A total of 226,737 individuals (7,958 [3.5%] cases and 218,779 [96.5%] controls) were included in the final analysis. The ratio of newly diagnosed AA was 18/7,958 (0.2%) in cases and 195/218,779 (0.1%) in controls. IRRs of COVID-19 patients having newly diagnosed AA compared to controls were 0.78 (95% CI: 0.48–1.27) when age and sex were adjusted for and 0.60 (95% CI: 0.35–1.03) when all demographic variables were adjusted for.Conclusion: Diagnosis of COVID-19 was not significantly associated with the development of AA even after appropriately adjusting for covariates.

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Section: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lack of Evidence of COVID-19 Being a Risk Factor of Alopecia Areata: Results of a National Cohort Study in South Korea

et al. 2021

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“…

We read with interest the recent report titled "New onset of alopecia areata in a patient with SARS-COV-2 infection: Possible pathogenetic correlations?" by Rossi et al 1 The authors report on a 29-year-old woman who developed alopecia areata-total is one month after recovering from SARS-Cov-2 infection and ponder the underlying mechanistic pathways. 1 Similar additional cases of AA developing in association with COVID-19 infection have been reported and one study demonstrated an increase in the percentage of patients with AA from 0.0097% to 0.0148% between May 2019 and May 2020.

…”

mentioning

confidence: 99%

Letter to the editor regarding the article ‘‘Rossi A, Magri F, Michelini S, et al. New onset of alopecia areata in a patient with SARS‐COV‐2 infection: Possible pathogenetic correlations? J Cosmet Dermatol. 2021 Mar 19. doi: 10.1111/jocd.14080”

Abou-Rahal

Abdullah

Kurban

et al. 2021

J of Cosmetic Dermatology

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We read with interest the recent report titled "New onset of alopecia areata in a patient with SARS-COV-2 infection: Possible pathogenetic correlations?" by Rossi et al. 1 The authors report on a 29-year-old woman who developed alopecia areata-total is one month after recovering from SARS-Cov-2 infection and ponder the underlying mechanistic pathways. 1 Similar additional cases of AA developing in association with COVID-19 infection have been reported and one study demonstrated an increase in the percentage of patients with AA from 0.0097% to 0.0148% between May 2019 and May 2020. 1,2 Given this unfolding association, we here intend to highlight a possible role that the plasmacytoid dendritic cells (pDCs)

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Autoimmune and Autoinflammatory Connective Tissue Disorders Following COVID-19

Lim,

Ju,

Han

et al. 2023

JAMA Netw Open

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ImportanceMultiple cases of autoimmune and autoinflammatory diseases after COVID-19 have been reported. However, their incidences and risks have rarely been quantified.ObjectiveTo investigate the incidences and risks of autoimmune and autoinflammatory connective tissue disorders after COVID-19.Design, Setting, and ParticipantsThis was a retrospective population-based study conducted between October 8, 2020, and December 31, 2021, that used nationwide data from the Korea Disease Control and Prevention Agency COVID-19 National Health Insurance Service cohort and included individuals who received a diagnosis of COVID-19 via polymerase chain reaction testing and a control group with no evidence of COVID-19 identified from National Health Insurance Service of Korea cohort. Data analysis was conducted from September 2022 to August 2023.ExposuresReceipt of diagnosis of COVID-19.Main Outcomes and MeasuresThe primary outcomes were the incidence and risk of autoimmune and autoinflammatory connective tissue disorders following COVID-19. A total of 32 covariates, including demographics, socioeconomic statuses, lifestyle factors, and comorbidity profiles, were balanced through inverse probability weighting. The incidences and risks of autoimmune and autoinflammatory connective tissue disorders were compared between the groups using multivariable Cox proportional hazard analyses.ResultsA total of 354 527 individuals with COVID-19 (mean [SD] age, 52.24 [15.55] years; 179 041 women [50.50%]) and 6 134 940 controls (mean [SD] age, 52.05 [15.63] years; 3 074 573 women [50.12%]) were included. The risks of alopecia areata (adjusted hazard ratio [aHR], 1.12; 95% CI, 1.05-1.19), alopecia totalis (aHR, 1.74; 95% CI, 1.39-2.17), antineutrophil cytoplasmic antibody–associated vasculitis (aHR, 2.76; 95% CI, 1.64-4.65), Crohn disease (aHR, 1.68; 95% CI, 1.31-2.15), and sarcoidosis (aHR, 1.59; 95% CI, 1.00-2.52) were higher in the COVID-19 group. The risks of alopecia totalis, psoriasis, vitiligo, vasculitis, Crohn disease, ulcerative colitis, rheumatoid arthritis, adult-onset Still disease, Sjögren syndrome, ankylosing spondylitis, and sarcoidosis were associated with the severity of COVID-19.Conclusions and RelevanceIn this retrospective cohort study, COVID-19 was associated with a substantial risk for autoimmune and autoinflammatory connective tissue disorders, indicating that long-term management of patients with COVID-19 should include evaluation for such disorders.

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New onset of alopecia areata in a patient with SARS‐CoV‐2 infection: Possible pathogenetic correlations?

Abstract: determining the current pandemic. It is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an RNA

Cited by 36 publications

References 6 publications

Lack of Evidence of COVID-19 Being a Risk Factor of Alopecia Areata: Results of a National Cohort Study in South Korea

Lack of Evidence of COVID-19 Being a Risk Factor of Alopecia Areata: Results of a National Cohort Study in South Korea

Letter to the editor regarding the article ‘‘Rossi A, Magri F, Michelini S, et al. New onset of alopecia areata in a patient with SARS‐COV‐2 infection: Possible pathogenetic correlations? J Cosmet Dermatol. 2021 Mar 19. doi: 10.1111/jocd.14080”

Autoimmune and Autoinflammatory Connective Tissue Disorders Following COVID-19

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