Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, New York.
Center for Research Informatics and Innovation, The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York.
J Am Acad Dermatol. 2021 Apr;84(4):946-952. doi: 10.1016/j.jaad.2020.12.046. Epub 2020 Dec 25.
Limited information exists on mucocutaneous disease and its relation to course of COVID-19.
To estimate prevalence of mucocutaneous findings, characterize morphologic patterns, and describe relationship to course in hospitalized adults with COVID-19.
Prospective cohort study at 2 tertiary hospitals (Northwell Health) between May 11, 2020 and June 15, 2020.
Among 296 hospitalized adults with COVID-19, 35 (11.8%) had at least 1 disease-related eruption. Patterns included ulcer (13/35, 37.1%), purpura (9/35, 25.7%), necrosis (5/35, 14.3%), nonspecific erythema (4/35, 11.4%), morbilliform eruption (4/35, 11.4%), pernio-like lesions (4/35, 11.4%), and vesicles (1/35, 2.9%). Patterns also showed anatomic site specificity. A greater proportion of patients with mucocutaneous findings used mechanical ventilation (61% vs 30%), used vasopressors (77% vs 33%), initiated dialysis (31% vs 9%), had thrombosis (17% vs 11%), and had in-hospital mortality (34% vs 12%) compared with those without mucocutaneous findings. Patients with mucocutaneous disease were more likely to use mechanical ventilation (adjusted prevalence ratio, 1.98; 95% confidence interval, 1.37-2.86); P < .001). Differences for other outcomes were attenuated after covariate adjustment and did not reach statistical significance.
Skin biopsies were not performed.
Distinct mucocutaneous patterns were identified in hospitalized adults with COVID-19. Mucocutaneous disease may be linked to more severe clinical course.
关于黏膜皮肤疾病及其与 COVID-19 病程的关系，相关信息有限。
评估住院成人 COVID-19 患者黏膜皮肤病变的患病率，描述其形态学模式，并探讨其与病程的关系。
这是一项于 2020 年 5 月 11 日至 6 月 15 日在 2 家三级医院（Northwell Health）进行的前瞻性队列研究。
在 296 例住院 COVID-19 患者中，有 35 例（11.8%）至少有一种与疾病相关的皮疹。病变类型包括溃疡（13/35，37.1%）、紫癜（9/35，25.7%）、坏死（5/35，14.3%）、非特异性红斑（4/35，11.4%）、麻疹样皮疹（4/35，11.4%）、冻疮样病变（4/35，11.4%）和水疱（1/35，2.9%）。病变还具有解剖部位的特异性。与无黏膜皮肤病变的患者相比，有黏膜皮肤病变的患者使用机械通气（61% vs. 30%）、血管加压素（77% vs. 33%）、开始透析（31% vs. 9%）、发生血栓（17% vs. 11%）和院内死亡率（34% vs. 12%）的比例更高。患有黏膜皮肤疾病的患者使用机械通气的可能性更高（调整后的患病率比，1.98；95%置信区间，1.37-2.86）；P<.001）。其他结局的差异在调整协变量后减弱，且无统计学意义。
未进行皮肤活检。
在住院的 COVID-19 成人患者中，发现了不同的黏膜皮肤病变模式。黏膜皮肤疾病可能与更严重的临床病程有关。
