Post-SARS-CoV-2 Acute Telogen Effluvium: An Expected Complication

Abstract

Post-SARS-CoV-2 telogen effluvium has been described in case reports of COVID-19 patients. We evaluated the prevalence of post-SARS-CoV-2 telogen effluvium in patients from a single medical center, exploring any causal links with the infection. Our hospital-based, cross-sectional study was conducted with patient participants discharged with a diagnosis of SARS-CoV-2 pneumonia from 1 March to 4 April 2020. All patients were evaluated by the same senior dermatologist; a clinical/dermatoscopic evaluation was performed. Alopecia was assessed in 31.3% of patients, with a significant difference in sex (females 73%, males 26.7%). The average time detected from the onset of the first symptoms to alopecia was 68.43 days. Overall, there were no significant associations between alopecia and COVID-19-related features (length of hospitalization, virologic positivity, or duration of fever), treatment characteristics, or laboratory findings. In this paper, we report that post-infection acute telogen effluvium occurs in a significant number of COVID-19 patients. The burden of this condition may impair the quality of life, with a significant impact on individuals.

Hair Loss and Telogen Effluvium Related to COVID-19: The Potential Implication of Adipose-Derived Mesenchymal Stem Cells and Platelet-Rich Plasma as Regenerative Strategies

“…Monari et al [ 26 ], in a cross-sectional study which enrolled 96 patients with a diagnosis of SARS-CoV-2 pneumonia, identified TE in 31.3% of patients, with a significant difference in sex (females 73%, males 26.7%). The average time detected from the onset of the first symptoms to TE was 68.43 days.…”

A Systematic Review and Quality Evaluation of Studies on Long-Term Sequelae of COVID-19

“…We included eight studies in the dermatological section (Table 5). The most common affection reported was telogen effluvium, often reported between 1 to 3 months post infection [45][46][47][48][49][50][51]. Other clinical findings are low hair density and softer hair, which marks positive to the traction test, and empty follicles using trichoscopy and Trichogramma [45][46][47][48][49][50][51].…”

“…The most common affection reported was telogen effluvium, often reported between 1 to 3 months post infection [45][46][47][48][49][50][51]. Other clinical findings are low hair density and softer hair, which marks positive to the traction test, and empty follicles using trichoscopy and Trichogramma [45][46][47][48][49][50][51]. The least common hair-loss pattern was the bitemporal-frontal in 5.12% of cases, followed by front vertical in 7.69% and occipital in 12.82%; the most common pattern was the bitemporal and diffuse affection in 30.76% and 43.58%, respectively [46].…”

“…For example, Aksoy et al observed that after COVID-19 recovery, 42.3% of women and 6.2% of men reported telogen effluvium [47]. Monari et al reported similar proportions with 73.3% and 26.7% respectively [49]. A study including 204 patients observed that telogen effluvium developed in 57 patients, from which 31.7% had a hospitalization history and 24.3% were outpatients [47].…”

“…A study including 204 patients observed that telogen effluvium developed in 57 patients, from which 31.7% had a hospitalization history and 24.3% were outpatients [47]. It is still unclear the physiopathological mechanism behind hair loss; however, a proinflammatory cascade with high levels of cytokines was postulated as the main reason, followed by the use of a multidrug regimen during the acute phase of COVID-19 [49,52]. Anya.…”