Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawaii, USA.
Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, 2-5-1 Shikata-cho, Okayama, Japan.
J Cosmet Dermatol. 2022 Sep;21(9):3655-3662. doi: 10.1111/jocd.15218. Epub 2022 Jul 19.
While there are literature reporting increased incidence of hair loss in COVID-19 patients, insufficient evidence exists on the topic to date. This review aims to identify the existing evidence and clinical characteristics of hair loss with COVID-19 infection.
Following the PRISMA Extension for Scoping Reviews, MEDLINE and EMBASE were searched for all peer-reviewed articles with relevant keywords including "Alopecia," "Telogen Effluvium (TE)," and "COVID-19" from their inception to November 20, 2021.
A total of 26 articles, with 9 observational studies and 17 case reports or series (a total of 58 cases), were included. Most studies dealt with TE. There were no clear trends between COVID-19 severity and the extent of hair loss. Analysis of the 58 cases also found similar results with most of the cases being female (82.8%), the median onset of hair loss of 2.0 months, and the median time to recovery of hair loss of 5.0 months with a resolution rate of 95%.
While this systematic review revealed uncertainty and a lack of strong evidence regarding the association of COVID-19 and hair loss, hair loss in COVID-19 may mainly include TE and be reversible in nature. Future studies are warranted to determine the detailed pathophysiology and risk factors of hair loss in COVID-19, including possible roles of estrogen, progesterone, and pro-inflammatory cytokines.
虽然有文献报道 COVID-19 患者脱发的发病率增加,但目前关于这一主题的证据还不够充分。本综述旨在确定与 COVID-19 感染相关的脱发的现有证据和临床特征。
按照 PRISMA 扩展范围审查指南,检索 MEDLINE 和 EMBASE 数据库,使用包括“脱发”、“休止期脱发(TE)”和“COVID-19”在内的所有相关关键词,检索时间从建库至 2021 年 11 月 20 日的同行评议文章。
共纳入 26 篇文章,其中 9 项为观察性研究,17 项为病例报告或系列研究(共 58 例)。大多数研究涉及 TE。COVID-19 严重程度与脱发程度之间没有明显的趋势。对 58 例病例的分析也得出了类似的结果,大多数病例为女性(82.8%),脱发的中位发病时间为 2.0 个月,脱发恢复的中位时间为 5.0 个月,缓解率为 95%。
虽然这项系统综述显示 COVID-19 与脱发之间的关联存在不确定性和缺乏强有力的证据,但 COVID-19 引起的脱发可能主要包括 TE,且具有自限性。需要进一步的研究来确定 COVID-19 脱发的详细病理生理学和危险因素,包括雌激素、孕激素和促炎细胞因子可能的作用。