de Aguiar Beatriz Regina Lima, Ferreira Elaine Barros, De Luca Canto Graziela, Guerra Eliete Neves Silva, Dos Reis Paula Elaine Diniz
Health Science Graduate Program, School of Health Sciences, University of Brasilia, Brasília, Brazil.
Interdisciplinary Laboratory of Research Applied to Clinical Practice in Oncology, School of Health Sciences, University of Brasilia, Brasília, Brazil.
Front Med (Lausanne). 2024 Aug 21;11:1390775. doi: 10.3389/fmed.2024.1390775. eCollection 2024.
COVID-19 presents extrapulmonary manifestations that can aid in the diagnosis. Skin manifestations have been reported but their characteristics are not yet clear. Health professionals need information about its prevalence and main characteristics.
This systematic review followed the PRISMA criteria. The protocol was registered in the PROSPERO (number CRD42020193173). Seven electronic databases and the gray literature were searched independently by two researchers. Observational analytical studies that presented data on the prevalence of skin manifestations in patients aged 19 or older with COVID-19 were included. Prevalence estimates were synthesized through a meta-analysis using random-effects models. Association meta-analysis and comparisons were performed for individual characteristics.
We included 31 studies with 10,934 patients, of which 10,121 tested positive for COVID-19. The general prevalence of skin manifestations was 29% (95% CI: 17.0-43.0; I: 99%), the most in Africa, with a mean duration between 7 and 9 days and the most frequently affecting feet+hands (75%) and the trunk (71%). Patients with mild/moderate COVID-19 had more of chilblain-like+pernio-like lesions (97%) and inflammatory lesions (86%) than patients with severe or critical COVID-19. Manifestations of vascular origin were only in elderly patients and were significant with the severity of COVID-19 ( = 0).
The global prevalence of skin manifestations is similar to other signs and symptoms of COVID-19. Skin assessment should be considered when investigating and diagnosing COVID-19 in adult and elderly patients.: PROSPERO, identifier CRD42020193173, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020193173.
新型冠状病毒肺炎（COVID-19）存在有助于诊断的肺外表现。皮肤表现已有报道，但其特征尚不清楚。卫生专业人员需要了解其患病率和主要特征的信息。
本系统评价遵循PRISMA标准。该方案已在国际前瞻性系统评价注册库（PROSPERO，注册号CRD42020193173）注册。由两名研究人员独立检索七个电子数据库和灰色文献。纳入了关于19岁及以上COVID-19患者皮肤表现患病率数据的观察性分析研究。通过使用随机效应模型的荟萃分析来综合患病率估计值。对个体特征进行关联荟萃分析和比较。
我们纳入了31项研究，共10934例患者，其中10121例COVID-19检测呈阳性。皮肤表现的总体患病率为29%（95%置信区间：17.0 - 43.0；I²：99%），在非洲最为常见，平均持续时间为7至9天，最常累及足部和手部（75%）以及躯干（71%）。与重症或危重症COVID-19患者相比，轻/中度COVID-19患者的冻疮样+冻疮样病变（97%）和炎症性病变（86%）更多。血管源性表现仅见于老年患者，且与COVID-19的严重程度显著相关（P = 0）。
皮肤表现的全球患病率与COVID-19的其他体征和症状相似。在对成年和老年患者进行COVID-19调查和诊断时，应考虑皮肤评估。：国际前瞻性系统评价注册库，标识符CRD42020193173，https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020193173 。
