Mascitti Hélène, Bonsang Benjamin, Dinh Aurélien, Assan Florence, Perronne Véronique, Leblanc Thibault, Duran Clara, Bouchand Frédérique, Matt Morgan, Le Gal Aurélie, N'guyen Van Thanh Julia, Lanore Aymeric, Jacob Louis, Kiavue Nicolas, Siméon Soline, Bessis Simon, de Truchis Pierre, Landowski Stéphanie, Davido Benjamin, Moreau Frédérique, Rameix-Welti Marie-Anne, Gault Elyanne, Gaillard Jean-Louis, Roux Anne-Laure, Sivadon-Tardy Valérie, Salomon Elsa, El Sayed Faten, Carlier Robert, Emile Jean-François, Perronne Christian, Bourgault-Villada Isabelle
Infectious and Tropical Diseases Unit, Raymond Poincaré University Hospital, AP-HP Paris Saclay University, Garches, France.
Department of Pathological Anatomy and Cytology, Ambroise Paré University Hospital, AP-HP Paris Saclay University, Boulogne-Billancourt, France.
Open Forum Infect Dis. 2020 Oct 18;7(11):ofaa394. doi: 10.1093/ofid/ofaa394. eCollection 2020 Nov.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a current pandemic worldwide. This virus can reach all organs and disturbs the immune system, leading to a cytokine storm in severe forms. We aimed to report cutaneous features among coronavirus disease 2019 (COVID-19) hospitalized patients.
We performed a cross-sectional study on 1 given day among all patients hospitalized in acute care for COVID-19 and included all patients with cutaneous features. Follow-up 48 hours later was obtained.
Among 59 adult patients hospitalized on the day of the study in an infectious diseases ward for SARS-CoV-2 infection who were confirmed by molecular assay and/or radiological findings (computed tomography scan), 40 were included. Several cutaneous manifestations were found: macular exanthema (80%), face edema (32%), livedo (13%), urticarial rash (8%), purpura (5%), oral lichenoid lesions (33%), and conjunctivitis (18%). Cutaneous biopsy was performed in 17 patients. Histological findings showed mast cell hyperplasia (100%), superficial perivascular infiltrate of lymphocytes (94%), and superficial edema (47%) consistent with capillary leak.
Various dermatological signs can be encountered during COVID-19. A macular rash was the most frequent. All cutaneous features could be related to a vascular leak process.
严重急性呼吸综合征冠状病毒2(SARS-CoV-2)是当前全球大流行的病原体。这种病毒可侵袭所有器官并扰乱免疫系统,在重症患者中导致细胞因子风暴。我们旨在报告2019冠状病毒病(COVID-19)住院患者的皮肤表现。
我们在某一天对所有因COVID-19入住急症科的患者进行了一项横断面研究,纳入所有有皮肤表现的患者。48小时后进行了随访。
在研究当天入住传染病病房的59例成年患者中,经分子检测和/或影像学检查(计算机断层扫描)确诊为SARS-CoV-2感染,其中40例被纳入研究。发现了几种皮肤表现:斑疹(80%)、面部水肿(32%)、网状青斑(13%)、荨麻疹样皮疹(8%)、紫癜(5%)、口腔苔藓样病变(33%)和结膜炎(18%)。对17例患者进行了皮肤活检。组织学检查结果显示肥大细胞增生(100%)、淋巴细胞血管周围浅层浸润(94%)和与毛细血管渗漏一致的浅层水肿(47%)。
COVID-19患者可出现多种皮肤体征。斑疹最为常见。所有皮肤表现可能都与血管渗漏过程有关。