Paucity of cutaneous manifestations of COVID-19 among inpatients at a referral hospital in India

Abstract

Background Varied cutaneous manifestations have been described in COVID-19, but most studies are based on photographic or app-based observation without directly observed evaluation by dermatologists . Objectives To study the types of cutaneous manifestations of COVID-19 among confirmed inpatients admitted to COVID-19 wards and ICUs. Methods This cross-sectional analysis was conducted at a referral hospital in Delhi, India. Four hundred and forty consecutive RT-PCR confirmed cases diagnosed with moderate or severe COVID-19 disease admitted in COVID-19 wards or ICUs, respectively, were included. A cutaneous finding was considered associated with COVID-19 if it had been described earlier as a consequence of COVID-19 and was observed at or within the first 48 hours of admission (after excluding drugs and comorbidities as causes). Results 270 patients were admitted to COVID wards with moderate COVID-19 disease, while 170 were in ICUs with severe disease. Only 7/270 ward patients (2.59%) and 3/170 ICU patients (1.76%) had cutaneous findings associated with COVID-19. Conclusion Cutaneous findings attributable to COVID-19 are infrequent, and we believe they may have been overestimated/overemphasized in earlier studies. Though coagulopathic findings may be associated with severe COVID-19, an association cannot be established in the absence of case-control studies.