tetano
Editor, Senior Moderator
Hong Kong Med J
. 2023 Oct 19.
doi: 10.12809/hkmj2210199. Online ahead of print. Cutaneous manifestations, viral load, and prognosis among hospitalised patients with COVID-19: a cohort study
C S M Wong[SUP] 1 [/SUP], I F N Hung[SUP] 2 [/SUP], M Y W Kwan[SUP] 3 [/SUP], M M H Chung[SUP] 1 [/SUP], M W M Chan[SUP] 1 [/SUP], A K C Cheng[SUP] 1 [/SUP], Y M Lau[SUP] 1 [/SUP], C K Yeung[SUP] 1 [/SUP], H H L Chan[SUP] 1 [/SUP], C S Lau[SUP] 4 [/SUP]
Affiliations
Introduction: Various cutaneous manifestations have been reported as symptoms of coronavirus disease 2019 (COVID-19), which may facilitate early clinical diagnosis and management. This study explored the incidence of cutaneous manifestations among hospitalised patients with COVID-19 and investigated its relationships with viral load, co-morbidities, and outcomes.
Methods: This retrospective study included adult patients admitted to a tertiary hospital for COVID-19 from July to September 2020. Clinical information, co-morbidities, viral load (cycle threshold [Ct] value), and outcomes were analysed.
Results: In total, 219 patients with confirmed COVID-19 were included. Twenty patients presented with new onset of rash. The incidence of new rash was 9.1% (95% confidence interval=6.25%-14.4%). The most common manifestations were maculopapular exanthem (n=6, 42.9%, median Ct value: 24.8), followed by livedo reticularis (n=4, 28.6%, median Ct value: 21.3), varicella-like lesions (n=2, 14.3%, median Ct value: 19.3), urticaria (n=1, 7.1%, median Ct value: 14.4), and acral chilblain and petechiae (n=1, 7.1%, median Ct value: 33.1). The median Ct values for patients with and without rash were 22.9 and 24.1, respectively (P=0.58). There were no significant differences in mortality or hospital stay between patients with and without rash. Patients with rash were more likely to display fever on admission (P<0.01). Regardless of cutaneous manifestations, patients with older age, hypertension, and chronic kidney disease stage ≥3 had significantly higher viral load and mortality (P<0.05).
Conclusion: This study revealed no associations between cutaneous manifestation and viral load or clinical outcomes. Older patients with multiple co-morbidities have risks of high viral load and mortality; they should be closely monitored.
Keywords: COVID-19; Exanthema; Hypertension; Mortality; Viral load.
. 2023 Oct 19.
doi: 10.12809/hkmj2210199. Online ahead of print. Cutaneous manifestations, viral load, and prognosis among hospitalised patients with COVID-19: a cohort study
C S M Wong[SUP] 1 [/SUP], I F N Hung[SUP] 2 [/SUP], M Y W Kwan[SUP] 3 [/SUP], M M H Chung[SUP] 1 [/SUP], M W M Chan[SUP] 1 [/SUP], A K C Cheng[SUP] 1 [/SUP], Y M Lau[SUP] 1 [/SUP], C K Yeung[SUP] 1 [/SUP], H H L Chan[SUP] 1 [/SUP], C S Lau[SUP] 4 [/SUP]
Affiliations
- PMID: 37853787
- DOI: 10.12809/hkmj2210199
Introduction: Various cutaneous manifestations have been reported as symptoms of coronavirus disease 2019 (COVID-19), which may facilitate early clinical diagnosis and management. This study explored the incidence of cutaneous manifestations among hospitalised patients with COVID-19 and investigated its relationships with viral load, co-morbidities, and outcomes.
Methods: This retrospective study included adult patients admitted to a tertiary hospital for COVID-19 from July to September 2020. Clinical information, co-morbidities, viral load (cycle threshold [Ct] value), and outcomes were analysed.
Results: In total, 219 patients with confirmed COVID-19 were included. Twenty patients presented with new onset of rash. The incidence of new rash was 9.1% (95% confidence interval=6.25%-14.4%). The most common manifestations were maculopapular exanthem (n=6, 42.9%, median Ct value: 24.8), followed by livedo reticularis (n=4, 28.6%, median Ct value: 21.3), varicella-like lesions (n=2, 14.3%, median Ct value: 19.3), urticaria (n=1, 7.1%, median Ct value: 14.4), and acral chilblain and petechiae (n=1, 7.1%, median Ct value: 33.1). The median Ct values for patients with and without rash were 22.9 and 24.1, respectively (P=0.58). There were no significant differences in mortality or hospital stay between patients with and without rash. Patients with rash were more likely to display fever on admission (P<0.01). Regardless of cutaneous manifestations, patients with older age, hypertension, and chronic kidney disease stage ≥3 had significantly higher viral load and mortality (P<0.05).
Conclusion: This study revealed no associations between cutaneous manifestation and viral load or clinical outcomes. Older patients with multiple co-morbidities have risks of high viral load and mortality; they should be closely monitored.
Keywords: COVID-19; Exanthema; Hypertension; Mortality; Viral load.