Skin and gastrointestinal symptoms in COVID-19

Ciechanowicz, Piotr; Lewandowski, Konrad; Szymańska, Elżbieta; Kaniewska, Magdalena; Rydzewska, Grażyna; Walecka, Irena

doi:10.5114/pg.2020.101558

Cited by 7 publications

(8 citation statements)

References 59 publications

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“…The close connection established in our study between urticarial rash and gastrointestinal symptoms is fascinating because it shows that this pattern is indicative of COVID‐19‐associated gastrointestinal involvement, an observation that coincides with Marzano et al's article 18 . The relationship between urticarial and intestinal symptoms might be due to “cytokine storm” triggered by SARS‐CoV‐2 20 . However, no association was found between it and any other cutaneous patterns.…”

Section: Discussionsupporting

confidence: 81%

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Cutaneous manifestations of Coronavirus Disease 2019

Ghafoor

Ali

Goldust

2022

J of Cosmetic Dermatology

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Background COVID‐19 has been linked to a variety of dermatological conditions. Objective To determine the presence of various cutaneous manifestations in patients with COVID‐19, also to define their features in relation to the systemic symptoms. Methods This research enrolled a total of 1206 lab‐confirmed COVID‐19 individuals at a tertiary care hospital in Karachi, Pakistan. Expert dermatologists assessed patients for COVID‐related skin conditions. COVID‐19 severity was categorized as asymptomatic/mild, moderate, or severe. Results Of the 102 (85.7%) patients with only one cutaneous sign, 26.5% developed maculo‐papular/morbiliform/erythematous rash; 14.7% urticaria; 9.85% vesicular/pustular exanthem; 14.7% vascular pattern; 12.7% infections, 7.8% miscellaneous and 9.8% late cutaneous findings A longer‐lasting vascular pattern was related with an older age and a fatal COVID‐19 outcomes (P: 0.000) compared to mild/moderate disease. Most of the retiform purpura presented exclusively with thromboembolic episodes. The moderate severity was correlated with maculopapular/morbiliform/exanthematous phenotype (P: 0.009), whereas urticaria was attributed to asymptomatic/mild disease (0.001) compared to moderate/severe infection. Limitations Single‐Centre and observational study. Conclusion Vascular lesions were correlated with disastrous COVID‐19 outcomes, whereas retiform purpura was linked to adverse outcomes. The maculopapular/morbiliform/erythematous rash was associated with moderate severity, whilst the urticarial rash was linked to milder course compared to moderate/severe severity infection.

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Section: Discussionsupporting

confidence: 81%

“…18 The relationship between urticarial and intestinal symptoms might be due to "cytokine storm" triggered by SARS-CoV-2. 20 However, no association was found between it and any other cutaneous patterns. According to Algaadi's literature review, urticaria may be a diagnostic sign in COVID-19, 21 which is consistent with our findings.…”

Section: Re Sultsmentioning

confidence: 92%

Cutaneous manifestations of Coronavirus Disease 2019

Ghafoor

Ali

Goldust

2022

J of Cosmetic Dermatology

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“…The incubation of SARS-CoV-2 lasts from 2 to 14 days [38]. The most frequent signs in patients were fever, cough, fatigue, anosmia, ageusia, muscle pain, chills, sore throat, rhinitis, and headache head [11]. Additionally, gastrointestinal symptoms have been reported, diarrhea, stomach pain, vomiting, nausea, and poor appetite [11].…”

Section: Sars-cov-2mentioning

confidence: 99%

“…The most frequent signs in patients were fever, cough, fatigue, anosmia, ageusia, muscle pain, chills, sore throat, rhinitis, and headache head [11]. Additionally, gastrointestinal symptoms have been reported, diarrhea, stomach pain, vomiting, nausea, and poor appetite [11]. The nucleotide sequence of SARS-CoV-2 revealed about 51.8 and 79.0% of similarity with MERS-CoV and SARS-CoV-1, respectively, and is closely related to SARS-like coronavirus of bald origin-mouse (bat-SL-CoVZC45) with 87.6-89%…”

Section: Sars-cov-2mentioning

confidence: 99%

“…Usually, the transmission of SARS-CoV-2 was accounted occurs through inhalation of respiratory droplets diffused by coughing or sneezing from an infected patient, and through direct contact with contaminated surfaces or objects [10]. This respiratory syndrome leads to developing several chronic or acute disorders in patients such as fever, cough, fatigue, anosmia and ageusia, dyspnea, chest pain, muscle pain, chills, sore throat, rhinitis, headache [11], and gastrointestinal symptoms (nausea, vomiting, diarrhea) [11]. SARS-CoV-2 genomic RNA has been detected in patient stool and urine samples [12], suggesting the possibility that the virus may be transmitted via the fecal-oral route, besides droplet and fomite transmission.…”

Section: Introductionmentioning

confidence: 99%

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Emerging Human Coronaviruses (SARS-CoV-2) in the Environment Associated with Outbreaks Viral Pandemics

Ibrahim¹,

Hammami²,

Ghanmi³

et al. 2022

Wastewater Treatment

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In December 2019, there was a cluster of pneumonia cases in Wuhan, a city of about 11 million people in Hubei Province. The World Health Organization (WHO), qualified CoVid-19 as an emerging infectious disease on March 11, 2020, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which spreads around the world. Coronaviruses are also included in the list of viruses likely to be found in raw sewage, as are other viruses belonging to the Picornaviridae family. SRAS-CoV-2 has been detected in wastewater worldwide such as the USA, France, Netherlands, Australia, and Italy according to the National Research Institute for Public Health and the Environment. In addition, the SARS-CoV-2 could infect many animals since it has been noticed in pigs, domestic and wild birds, bats, rodents, dogs, cats, tigers, cattle. Therefore, the SARS-CoV-2 molecular characterization in the environment, particularly in wastewater and animals, appeared to be a novel approach to monitor the outbreaks of viral pandemics. This review will be focused on the description of some virological characteristics of these emerging viruses, the different human and zoonotic coronaviruses, the sources of contamination of wastewater by coronaviruses and their potential procedures of disinfection from wastewater.

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Multiple drugs

2021

Reactions Weekly

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Clostridium difficile diarrhoea, skin disorders and off-label use: 2 case reportsIn a study (Poland) involving 441 patients, who were diagnosed with Covid-19 between 15 March 2020 and 15 June 2020, two patients (1 man and 1 woman), aged 83-86 years were described, of whom an 83-year-old man developed Clostridium difficile infection (CDI) diarrhoea following treatment with ceftazidime, chloroquine and azithromycin, and developed erythematous rash, macular rash and pruritus following off-label treatment with chloroquine and azithromycin while an 86-year-old woman developed CDI diarrhoea following treatment with azithromycin (off-label), chloroquine (off-label), lopinavir/ritonavir (off-label), piperacillin/ tazobactam, ciprofloxacin and imipenem/cilastatin, and developed erythematous rash, macular rash, skin oedema and dermatitis exfoliative during treatment with azithromycin, chloroquine and lopinavir/ritonavir [dosages and times to reactions onsets not stated; not all routes and outcomes stated].An 83-year-old man was hospitalised with exacerbation of chronic obstructive pulmonary disease and SARS-CoV-2 infection. On admission, no dermal lesions was noted. On day 4 after introducing ceftazidime (because of fever and the picture of ground glass opacity visible in the CT of the chest), he developed diffuse erythematous infiltrated lesions within the trunk and limbs with the greatest severity on the back and buttocks. The dermal lesions were accompanied by pruritus. The use of clemastine [clemastinum] and clobetasol, and the discontinuation of ceftazidime in further treatment resulted in the marked reduction of dermal lesions and pruritus. Histopathological investigation revealed lesions within the epidermis, characterised by local acanthosis and atrophy. Hyperkeratotic lesions were noted on the surface of the mass and while elastosis or the features of skin atrophy were seen in the stromal layer. Numerous thin-walled vessels and perivascular inflammatory infiltrations of mononuclear cells and eosinophils were present subepidermally. The microscopic picture was suggestive of atrophic lesions, which may have been drug-induced. He was taking an unspecified proton pump inhibitor (PPI) due to dyspepsia. During his hospital stay, he was taking off-label chloroquine and off-label azithromycin for SARS-CoV-2 infection from the start of his hospitalisation. He developed diarrhoea (defined as >3 loose bowel movements) on day 3 of hospitalisation, and was diagnosed with CDI. CDI risk factors included age, hospitalisation, presence of comorbidities, proton pump inhibitor and antibiotic therapy. Vancomycin treatment was started. He had developed CDI diarrhoea due to ceftazidime, chloroquine and azithromycin, and erythematous rash, macular rash and pruritus due to chloroquine and azithromycin.An 86-year-old woman had hypertension, brain injury of vascular origin and two myocardial infarctions. She was admitted with confirmed SARS-CoV-2 infection, and the symptoms of an urinary tract infection. On admission she presented no der...

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Skin and gastrointestinal symptoms in COVID-19

Cited by 7 publications

References 59 publications

Cutaneous manifestations of Coronavirus Disease 2019

Cutaneous manifestations of Coronavirus Disease 2019

Emerging Human Coronaviruses (SARS-CoV-2) in the Environment Associated with Outbreaks Viral Pandemics

Multiple drugs

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