Skin Rash May Be a Symptom of COVID-19

AHA Publisher — Tue, 14 Jul 2020 07:00:30 +0000

Sally Robertson, B.Sc. via News-Medical Net – Researchers at King’s College London and Zoe Global Ltd have conducted a study suggesting that skin rashes could be valuable predictors of coronavirus disease 2019 (COVID-19). In a large community-based study, 8.8% of people who had tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) also reported having a skin rash. Among people who had not tested positive, but did report at least one classic symptom of COVID-19 symptom based on NHS guidelines, 8.2% also reported skin rashes. According to NHS guidelines, the three most common signs of COVID-19 are fever, persistent cough, and a reduced sense of smell (anosmia). Skin-related symptoms are not included, even though these can be easily spotted by patients, say Mario Falchi and team. The researchers say their findings strongly support including skin rashes, adding that although skin rashes are far less common than fever, they are much more specific and last longer. “Recognizing rashes is important in identifying new and earlier COVID-19 cases,” says the team. A pre-print version of the paper is available on the server medRxiv*, while the article undergoes peer review. The Link with Skin Manifestations Has Been Slow to Emerge It has become apparent during the COVID-19 pandemic that while the disease is primarily a respiratory illness, it also targets multiple organs, including the skin. Some studies have previously reported urticaria, chicken pox-like body rashes, and chilblains on the toes or fingers (acral rashes), possibly due to minor thrombotic events or damaged endothelium in small vessels of the digits. However, the link between COVID-19 and skin manifestations has been slower to emerge than it has for organs such as the heart, intestine, and brain. “COVID-19 rashes may present in many forms and at different stages of the disease. The heterogeneous presentations, the time delay, as well as the focus on severely ill patients during the early phases of the pandemic, led to the skin being overlooked as an important target organ for COVID-19,” say Falchi and colleagues. Now the researchers have used data available for 336,847 UK users of the COVID Symptom Study app to investigate the diagnostic value of skin rashes for infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The team also used data available for 11,546 people who participated in an independent survey on COVID-19-related skin symptoms. Skin Rashes Increased the Odds of SARS-CoV-2 Positivity More Than Fever Of 27,157 app users who provided swab test results, 2,021 (7.4%) were positive for SARS-CoV-2, and 25,136 (92.6%) were negative. Of the swab-positive individuals, 178 (8.8%) reported skin rashes (138 body rashes; 62 acral and 22 both body and acral), compared with 1357 (5.4%) of swab-negative individuals. Association analysis showed that the presence of body or acral rashes increased the likelihood of being swab positive for SARS-CoV-2 by 67%. This compares with fever increasing the odds of SARS-CoV-2 positivity by 47%, and fever is commonly used to screen for COVID, points out the team. Skin Rashes Were Also Predictive in Untested, But Symptomatic Users Among the 334,690 app users who did not provide a swab test result, 17,371 reported one of the three main symptoms (fever, persistent cough, and anosmia), which according to NHS guidelines, would require isolation and SARS-CoV-2 testing. Of those reporting one of the three typical symptoms, 8.2% also reported a skin rash, compared with 6% of untested users who did not report any of the three symptoms. Association analysis revealed that among untested users who reported one of the three main symptoms, the likelihood of having a body rash was 46% greater compared with those who did not report one of the symptoms. The increased likelihood of acral rash among those reporting a symptom was not statistically significant. The Findings Support the Inclusion of Skin Rashes as a Suspected Symptom To capture more information about the type, duration, and timing of rashes, the team analyzed data available for people 11,546 with a rash who participated in an independent survey on COVID-19-related skin symptoms. Among 694 responders who were positive for SARS-CoV-2 by swab or antibody test and provided information on COVID-19-related symptoms, the rash appeared before any other symptom in 17% of cases and in 21% of cases, the rash was the only symptom. “Twenty-one percent of the SARS-CoV-2 positive surveyees presented with skin symptoms alone and would have been missed if using the NHS classic symptoms alone,” write Falchi and colleagues. The researchers say the findings strongly support the inclusion of skin rashes as a suspected COVID-19 symptom. “Although, it is less prevalent than fever, it is more specific of COVID-19 and last longer,” they add. “An increased awareness from the public and healthcare professionals regarding COVID-19 skin changes will allow more efficient identification of new and earlier clusters of the disease,” concludes the team. *Important Notice medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information. To read the original article click here.

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Loss of Smell Hints at Coronavirus Infection

AHA Publisher — Fri, 03 Apr 2020 07:00:54 +0000

King’s College London via News-Medical Net – The most common signs and symptoms of coronavirus disease (COVID-19) include fever, dry cough, and difficulty of breathing. But patients who were infected recall another bizarre symptom tied to the coronavirus infection – loss of smell. Doctors from across the globe are reporting cases of patients with COVID-19 who experienced anosmia, or the loss of their sense of smell and others lose their sense of taste or ageusia. In the latest report based on the data gathered from the COVID Symptom Tracker app suggests that one symptom tied to coronavirus infection is losing one’s sense of taste and smell. The app, which was developed by scientists at King’s College London as part of a Twins UK study, focuses on determining the symptoms most experienced by patients diagnosed with coronavirus disease. App Symptoms Tracker The app was downloaded by about 1.5 million users between Mar. 24 and 29. Based on the analysis of the data gathered by the app, about 26 percent of all users reported one or more symptoms. About 1,702 of the users had the coronavirus test, where 579 people tested positive, and 1,123 had negative results. Among those who tested positive with COVID-19, 59 percent had experienced the loss of smell and taste. In fact, the symptoms can be a predictive factor in diagnosing COVID-19, or in having the person get a test, than self-reported fever. Fever can be caused by a variety of factors, unlike the loss of smell and taste, which were seen in previous coronavirus outbreaks. With all the information gathered by the users, the team developed a model to determine which combination of symptoms could predict positive COVID-19 cases. The team found that the most reliable predictor is the loss of smell and taste. Other symptoms of COVID-19 include fever, fatigue, persistent cough, loss of appetite, and abdominal pain. In some instances, people experience gastrointestinal symptoms, such as diarrhea. Further, the team found that nearly 13 percent of about 400,000 people reporting symptoms who had not yet been tested for COVID-19 are more likely to be infected by the virus, which means an extra 50,000 people are likely to have COVID-19 but have not been confirmed yet. The app was developed by King’s College London scientists, in partnership with the Guy’s and St. Thomas’ NHS Foundation Trust, a healthcare start-up called ZOE Global LTD, and the NIHR Biomedical Research Center. The app’s aim and purpose are to help researchers understand how the virus spreads, the progression of COVID-19, and how many people have symptoms. Loss of Smell Loss of smell happens with the common colds and other viral infections, especially those affecting the nose and throat. Reports from doctors who handled patients with coronavirus say that the loss of smell may be one of the first symptoms of COVID-19. In fact, doctors have reported that up to 70 percent of patients who tested positive for the coronavirus experience anosmia and ageusia. Some countries affected, such as Iran, China, Italy, Germany, and France have all reported cases of the coronavirus disease where patients reported a temporary loss in their sense of taste or smell. Both symptoms were found in many patients, even in the absence of other symptoms. Public Health England has received reports about anosmia as an early sign of COVID-19 infection. Hence, health officials urged health care personnel always to employ full personal protective equipment (PPE) when dealing with patients, especially if they report anosmia as a symptom. “This primary research is only possible thanks to the 1.8 million citizen scientists logging their symptoms every day. This also gives us an evolving map of the UK of where symptoms are occurring two to three weeks before a strain on the NHS, which is why it’s vital to continue logging your health and symptoms, even when you feel completely healthy, and encourage others to use the app,” Professor Tim Spector, lead researcher, said. Further research is needed to definitively show how our sense of smell is affected by COVID-19. Still, it appears that anosmia may signal an infection. To read the original article click here.

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Skin Rash May Be a Symptom of COVID-19

Loss of Smell Hints at Coronavirus Infection