Race, ethnicity, and comorbidities are critical factors in the diagnosis of telogen effluvium during the COVID-19 pandemic

Cline, Abigail; Jacobs, Ashley Keyes; Fonseca, Maira; Wu, Julia; Asrani, Falguni; Safai, Bijan; Glick, Sharon A.; McLellan, Beth N.; McMichael, Amy J.; Marmon, Shoshana

doi:10.1016/j.jaad.2021.03.099

Cited by 11 publications

(19 citation statements)

References 5 publications

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“…The presence of comorbidities has been shown to increase the risk of developing post‐COVID‐19 acute TE. In a case series of 10 patients with COVID‐19‐associated acute TE, 9 of them had underlying comorbidities 28 . Similarly, Mieczkowska et al 14 found that most (8 out of 10) acute TE patients had pre‐existing medical conditions.…”

Section: Discussionmentioning

confidence: 93%

“…A total of 632 patients with a history of COVID‐19 infection were included from 19 studies 8,9,14–30 . Out of these 632 patients, 465 patients reported hair loss after recovery from COVID‐19 and were subsequently diagnosed with acute TE.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 632 patients with a history of COVID-19 infection were included from 19 studies. 8,9,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Out of these 632 patients, 465 patients reported hair loss after recovery from COVID-19 and were subsequently diagnosed with acute TE. The median age of these patients was 44 years (which ranged from 34 to 64 years), with 67.5% of them being female.…”

Section: Resultsmentioning

confidence: 99%

“…In a case series of 10 patients with COVID-19-associated acute TE, 9 of them had underlying comorbidities. 28 Similarly, Mieczkowska et al 14 found that most (8 out of 10) acute TE patients had pre-existing medical conditions. However, observational studies with a larger sample size are needed to confirm this association.…”

Section: Management and Outcomes Of Acute Tementioning

confidence: 96%

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A systematic review of acute telogen effluvium, a harrowing post‐COVID‐19 manifestation

Hussain¹,

Agarwala

Iqbal

et al. 2021

Journal of Medical Virology

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This systematic review focuses on the clinical features, physical examination findings, outcomes, and underlying pathology of acute telogen effluvium (TE), a type of diffuse hair loss, occurring in coronavirus disease 2019 (COVID‐19) recovered patients. MEDLINE/PubMed and Embase databases were queried till October 2021 to identify studies reporting acute TE occurring after COVID‐19 recovery. Data were obtained from 19 studies, which included 465 patients who were diagnosed with acute TE. The median age of these patients was 44 years and 67.5% were females. The most common trichoscopic findings were decreased hair density, the presence of empty follicles, or short regrowing hair. The mean duration from COVID‐19 symptom onset to the appearance of acute TE was 74 days, which is earlier than classic acute TE. Most patients recovered from hair loss, while a few patients had persistent hair fall. Our results highlight the need to consider the possibility of post‐COVID‐19 acute TE in patients presenting with hair fall, with a history of COVID‐19 infection, in the context of COVID‐19 pandemic. Despite being a self‐limiting condition, hair loss post‐COVID‐19 is a stressful manifestation. Identifying COVID‐19 infection as a potential cause of acute TE will help the clinicians counsel the patients, relieving them from undue stress.

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Section: Discussionmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Management and Outcomes Of Acute Tementioning

confidence: 96%

See 2 more Smart Citations

A systematic review of acute telogen effluvium, a harrowing post‐COVID‐19 manifestation

Hussain¹,

Agarwala

Iqbal

et al. 2021

Journal of Medical Virology

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“…There are some reports in the literature stating that the incidence of TE increased during the pandemic period compared to the pre‐pandemic period. 2 , 3 , 4 In several reports, it has been stated that the average onset time of the hair shedding was 1–3 months after the diagnosis of COVID‐19. 5 , 6 , 7 , 8 , 9 , 10 …”

Section: Introductionmentioning

confidence: 99%

Evaluation of patients with telogen effluvium during the pandemic: May the monocytes be responsible for post COVID‐19 telogen effluvium?

Yıldırım

Erbağcı

Öğüt

2022

J of Cosmetic Dermatology

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Introduction: Telogen effluvium (TE) is one of the causes of non-scarring hair loss that occurred commonly 2-3 months after a triggering factor. It was reported that the incidence of TE increased during the COVID-19 (coronavirus disease 2019) pandemic.However, to date, there is no study evaluating the status of COVID-19 before the onset of hair loss in patients with TE. The aim of this study is to evaluate the patients with TE whether they had COVID-19 or not before the onset of their hair loss and to compare the demographic and clinical characteristics and laboratory parameters of those with and without a history of COVID-19. Method:We conducted an observational cohort study of TE patients. The diagnosis of TE depended on anamnesis and physical examination of the patients. Also, hair pull test was performed. Demographic data and the results of COVID-19 real-time polymerase chain reaction (RT-PCR) were recorded from the electronic medical records.Results: Totally, 181 patients with TE were included in the study. Sixty-four of patients (35.4%) had been diagnosed with COVID-19 before the hair loss started. The median duration of development of hair loss was 2 months (range 1-11 months, IQR 3) after COVID-19 diagnosis. In this group, 87.5% of patients (n = 56) had acute TE and 12.5% of patients (n = 8) had chronic TE. The rate of acute TE and the use of vitamin supplements were ignificantly higher (p < 0.001 and p = 0.027, respectively) and the monocyte count in peripheral blood was lower (p = 0.041) in the group diagnosed with COVID-19. Discussion and Conclusion:It was stated that monocytes and macrophages infected by SARS-CoV-2 can produce pro-inflammatory cytokines that play a crucial role in the development of COVID-19-related complications. Also, it was suggested that the number of monocytes tends to be lower in the late recovery stage. The lower monocyte count in patients with a history of COVID-19 in our study may be related to evaluating the patients in the late period of recovery and the migration of circulating monocytes to hair follicles. The history of COVID-19 must be questioned in patients with TE. It should be kept in mind that hair loss that develops after COVID-19 may be presented as chronic TE form too. The exact mechanisms of hair loss induced by COVID-19 are not fully explained; the roles of monocytes on the hair follicles may be one of the responsible mechanisms. How to cite this article: Koç Yıldırım S, Erbağcı E, Demirel Öğüt N. Evaluation of patients with telogen effluvium during the pandemic: May the monocytes be responsible for post COVID-19 telogen effluvium?

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58-Year-Old Female with Diffuse Thinning of the Hair

Kirk

Castellanos

Sampath

et al. 2022

Clinical Cases in Alopecia

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Race, ethnicity, and comorbidities are critical factors in the diagnosis of telogen effluvium during the COVID-19 pandemic

Cited by 11 publications

References 5 publications

A systematic review of acute telogen effluvium, a harrowing post‐COVID‐19 manifestation

A systematic review of acute telogen effluvium, a harrowing post‐COVID‐19 manifestation

Evaluation of patients with telogen effluvium during the pandemic: May the monocytes be responsible for post COVID‐19 telogen effluvium?

58-Year-Old Female with Diffuse Thinning of the Hair

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