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    Cutaneous manifestations associated with  COVID-19 MESHD in children: A Systematic Review

    Authors: Seema Shah; Kiran Akhade; Satyaki Ganguly; Rachita Nanda; Eli Mohapatra; Anil Kumar Goel

    doi:10.21203/rs.3.rs-45314/v1 Date: 2020-07-18 Source: ResearchSquare

    Background: Cutaneous manifestation of COVID 19 in children has not yet been reviewed systematically and hence this review gives a future direction to the clinicians to be vigilant for skin presentations during such pandemic.Methodology: The review was done as per the guidelines of PRISMA and literature search was done on PubMed database using keywords as COVID-19 MESHD, children and skin in different combinations. Articles published in English with cases of age 1 month to 18 years were eligible. The outcome included varied aspects of cutaneous and COVID-19 MESHD infection. The review protocol was not registered.Results: Of 51 publications identified, 13 studies containing 149 children met the eligibility criteria. Acrally located erythematous maculopapular lesion MESHD was the most common finding in 138 children. Erythema multiforme MESHD, varicella like exanthem and Kawasaki disease MESHD like presentations were reported in the rest of the cases. The duration of the skin lesion MESHD was 1-2 weeks in 43%. Skin biopsy done in 18 cases revealed superficial & deep perivascular and peri-eccrine lymphocytic infiltrate & lymphocytic vasculitis. RT-PCR was positive in 13.8% cases. Serological markers for HSV, parvovirus B19 analyzed across various studies, were found negative, except for mycoplasma pneumoniae in 2 of 20 cases tested.Discussion: Clinicopathologic analysis established chilblains like lesion in 43% cases with no confirmed etiology like cold exposure, autoimmune dysfunction MESHD, drug reaction, or viral infection MESHD. The usual cephalo-caudal spread of a viral exanthem was also missing. However, a low number of discussed cases was a limitation of the study.Conclusion: In the absence of any confirmed etiology for such cutaneous manifestations, the possibility of  COVID-19 MESHD should be explored and evaluated thoroughly during such pandemic.

    Cutaneous Manifestations of COVID-19 MESHD: A Systematic Review

    Authors: Giulia Daneshgaran; Danielle P. Dubin; Daniel J. Gould

    doi:10.21203/rs.3.rs-33992/v1 Date: 2020-06-06 Source: ResearchSquare

    Background: The COVID-19 pandemic MESHD COVID-19 pandemic MESHD has affected 4.5 million people and killed over 300,000 patients. Although this virus primarily causes respiratory symptoms, an increasing number of cutaneous manifestations associated with this disease have been reported.Objective: The aim of this review was to collate and categorize the dermatologic findings reported in COVID-19 MESHD patients and identify specific lesions that may facilitate diagnosis and prognostication.Methods: A systematic review of the PubMed database was conducted on May 14th, 2020 using the search terms “ Covid-19 MESHD skin,” “ Covid-19 MESHD rash MESHD,” “ Covid-19 MESHD exanthem,” and “ Covid-19 MESHD chilblains.” Peer-reviewed publications containing original COVID-19 MESHD patient cases and a discussion of the associated cutaneous findings were included in the analysis.Results: The literature search identified 115 records, of which 34 publications describing 996 dermatologic patients were included. Case reports (n=15), case series (n=10) and observational studies (n=7) were the most common publication types. Pseudo-chilblains (PC) was the most frequent lesion identified (40.4% of cases), appearing in young adults (mean age, MA, 23.2 years) after the onset of extracutaneous COVID-19 MESHD symptoms (55/100 patients). Erythematous maculopapular rashes MESHD ( EMR MESHD) affected 21.3% of patients, most frequently impacting middle-aged adults (MA 53.2 years) and occurring at the same time as non-cutaneous symptoms (110/187 patients). Vesicular rashes MESHD ( VR MESHD) affected 13.0% of patients, appearing in middle-aged adults (MA 48.3 years) after the onset of other symptoms (52/84 patients). Urticarial rashes MESHD ( UR MESHD) affected 10.9% of patients, appearing in adults (MA 38.3 years) and occurring at the same time as non-cutaneous symptoms (46/78 patients). Vascular rashes MESHD resembling livedo/ purpura/necrosis MESHD (LPN) were uncommon (4% of cases), appearing in elderly patients (MA 77.5 years) and occurring at the same time as non-cutaneous COVID-19 MESHD symptoms (18/29 patients). Erythema multiforme-like eruptions MESHD ( EME MESHD), although infrequent (3.7% of cases), affected mostly children (MA 12.2 years).Conclusions: VR MESHD may suggest an initial diagnosis of COVID-19 MESHD, PC may be most appropriate for epidemiological uses, and LPN MESHD may be a useful prognostic marker for severe disease. As a potential correlate to disease severity, prognosis, or infectibility, it is critical that all health care professionals be well-versed in these increasingly common cutaneous manifestations of COVID-19 MESHD.  

The ZB MED preprint Viewer preVIEW includes all COVID-19 related preprints from medRxiv and bioRxiv, from ChemRxiv, from ResearchSquare, from arXiv and from Preprints.org and is updated on a daily basis (7am CET/CEST).
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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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