Diez-Domingo Javier, Parikh Raunak, Bhavsar Amit B, Cisneros Elisa, McCormick Natalia, Lecrenier Nicolas
FISABIO-Public Health, Valencia, Spain.
GSK, Wavre, Belgium.
Dermatol Ther (Heidelb). 2021 Aug;11(4):1119-1126. doi: 10.1007/s13555-021-00549-1. Epub 2021 May 17.
Herpes zoster (HZ) is associated with substantial morbidity. It is caused by reactivation of the latent varicella zoster virus (VZV) following decline in cell-mediated immunity, which is commonly age-related, but also occurs in individuals with immunosuppressive diseases and/or treatment. Since coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, has been associated with T cell immune dysfunction and there have been reports of HZ in COVID-19 patients, we have performed a review of available literature on whether COVID-19 could trigger HZ. We identified 27 cases of HZ following COVID-19, which most frequently occurred within 1-2 weeks of COVID-19, and the majority of cases had typical presentation. Atypical presentations of HZ were noted especially in patients with lymphopenia. It has been hypothesized that VZV reactivation occurs as a consequence of T cell dysfunction (including lymphopenia and lymphocyte exhaustion) in COVID-19 patients. Based on current evidence, which is limited to case reports and case series, it is not possible to determine whether COVID-19 increases the risk of HZ. Practitioners should be aware of the possible increased risk of HZ during the pandemic period and consider timely therapeutic and preventive measures against it.
带状疱疹（HZ）会引发严重疾病。它是由潜伏的水痘-带状疱疹病毒（VZV）在细胞介导免疫功能下降后重新激活所致，这种情况通常与年龄相关，但也会发生在患有免疫抑制性疾病和/或接受免疫抑制治疗的个体中。由于严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染引起的冠状病毒病（COVID-19）与T细胞免疫功能障碍有关，且有COVID-19患者发生HZ的报道，我们对关于COVID-19是否会引发HZ的现有文献进行了综述。我们确定了27例COVID-19后发生HZ的病例，这些病例最常发生在COVID-19后的1 - 2周内，且大多数病例表现典型。尤其是淋巴细胞减少的患者出现了HZ的非典型表现。据推测，COVID-患者中VZV重新激活是T细胞功能障碍（包括淋巴细胞减少和淋巴细胞耗竭）的结果。基于目前仅限于病例报告和病例系列的证据，无法确定COVID-19是否会增加HZ的风险。从业者应意识到在大流行期间HZ风险可能增加，并考虑及时采取针对它的治疗和预防措施。
