Skin manifestations in patients with COVID-19: a prospective observational study during the first wave of the pandemic in the UK and review of the recent literature

Abstract

Background COVID-19 (SARS-CoV-2) is a viral infection that presents in heterogeneous forms with effects on multiple organ systems including the skin. Objectives The objectives of this prospective observational study were to identify cutaneous lesions in confirmed COVID-19-positive patients admitted to a district general hospital in the eastern region of England, to determine the prevalence of these lesions and compare the findings with the current literature. Materials & Methods The study was conducted at the Luton and Dunstable University Hospital during the first peak of the pandemic in the United Kingdom to identify skin manifestations in patients infected with COVID-19. Several variables were taken into consideration and photographs of skin lesions were taken. Unlike previous similar studies, all patients included in this study had a positive nasopharyngeal PCR swab for SARS-CoV-2. All photographs were analysed by a dermatology consultant. Results A total of 93 patients were included in the study; 40% ( n = 37) had cutaneous lesions but only 5.5% of the total patients ( n = 6) presented with likely coronavirus-related skin changes. Lesions identified were pseudochilblain and purpuric/livedoid type. We also noted several coagulation abnormalities in these patients. Conclusion COVID-19 can present with a variety of skin manifestations. Pseudochilblain lesions and purpuric livedoid lesions have been described in the literature and although the underlying mechanism is not fully understood, it is possible that these lesions represent thromboinflammatory processes as a result of the hypercoagulability state associated with COVID-19. More research is required to better understand the pathophysiology and epidemiology of these manifestations. Supplementary data Supplementary data associated with this article can be found, in the online version, at doi: 10.1684/ejd.2022.4202.

Relationships Between Maternal Selected Metals (Cu, Mg, Zn and Fe), Thyroid Function and Blood Glucose Levels During Pregnancy

“…Mg2+ is an important cation and coenzyme involved in enzymatic reactions [ 23 ]. Studies have shown that Mg2+ is considered the second messenger of insulin and plays an important role in glucose metabolism stability and insulin sensitivity: i) Mg deficiency reduces insulin receptor activity, leading to insulin resistance and ii) hypomagnesemia inhibits glucose utilization in basal and insulin-stimulated states [ 24 ]. The inconsistent results may be due to the small sample size of women with GDM and differences among participants.…”