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At the Alessandro Manzoni Hospital in Lecco, northern Italy, it has been observed that a fifth of patients infected with the SARS-CoV-2 coronavirus have skin lesions.
Dermatoses appeared in 20,5 percent. out of 88 patients included in the study and were of a mixed nature. The most common were maculo-papular rash on an erythematous basis, urticaria and vesicular eruptions resembling varicella lesions, and rashes of creeping or linear erythematous changes were less frequent.
Eruptions most often appeared on the trunk and appeared after the end of hospitalization, and most importantly, their course did not correlate with the course of the respiratory disease caused by the SARS-CoV-2 virus. These skin rashes are non-specific and therefore similar to the eruptions that occur with other viral infections.
Importantly and clinically important – the presence of skin lesions may delay the diagnosis of COVID-19, as initially indicated by the described case of a patient hospitalized in Thailand, which is also the first recorded case of COVID-19 infection outside China.
In a patient with petechiae, diffuse haemorrhagic changes, thrombocytopenia and general symptoms (fever and muscle pain), the diagnosis of dengue haemorrhagic fever, an infectious transmission disease common in Southeast Asia, was misdiagnosed. Correct diagnosis – SARS-CoV-2 infection was only made in a center with a higher level of reference.
Similar opinions and observations appear in the United States. Professor Randy Jacobs from the University of California at Riverside describes the case of a 67-year-old patient whose initial symptoms – fever, nasal congestion, and a wet cough indicated a cold. A week later, he had symptoms of haematuria, weakness, and a red-purple patchy mosaic-stellar dermatosis appeared on the front surface of the thigh. The rash and hematuria stopped within one day, and the COVID-19 test came back positive. The patient was hospitalized in the intensive care unit, connected to oxygen therapy.
According to Dr. Jacobs, COVID-19 may lead to obstruction within small blood vessels – which is manifested, among others, by described dermatoses. It is unclear, however, whether the vascular occlusion occurs through a neurogenic, microclotting, or immunological mechanism.
The most common symptoms of coronavirus infection are fever, cough and shortness of breath.
As the pandemic unfolded, doctors began to observe other conditions that appeared in patients with COVID-19. For example, loss of smell and taste is relatively common in patients. Many infected complain of gastrointestinal symptoms such as diarrhea.
Patients also experience symptoms of a neurological nature, such as headaches and dizziness.
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