key: cord-0710016-xb6bk4o0
authors: Gaspari, Valeria; Orioni, Gionathan; Misciali, Cosimo; Viviani, Filippo; Zengarini, Corrado
title: COVID‐19 skin eruptions: incidence in hospitalized patients in Bologna
date: 2021-02-28
journal: Int J Dermatol
DOI: 10.1111/ijd.15509
sha: 60d73306d9c0cdb6a41cd4a6c2754ce2885dbba4
doc_id: 710016
cord_uid: xb6bk4o0

nan

SARS-CoV-2 was first isolated in China starting in December 2019, and the associated disease was termed Coronavirus Disease 2019 . By the end of January 2020, the epidemic had rapidly spread across the world, resulting in a pandemic condition. 1 Suspicion of COVID-19 is mainly made on clinical signs, vital parameters, and radiological settings. Oral-nasopharyngeal swab, allowing isolation of the virus, confirms the diagnosis. Finally, the patients' clinical records and anamnesis interview were acquired, and all cases considered were followed until hospital discharge. The incidence and differences between the COVID-19 hospitalized population and COVID-19 patients with skin signs were then calculated using frequency analysis, Fisher exact test, and student t-test for unpaired groups.

We performed a total of 68 bedside consults in COVID-19affected patients with any type of skin signs, accounting for 4.84% of the total. Of the latter, we diagnosed only 21 patients 3 (30% of requested consults) with skin signs likely related to SARS-CoV-2 infection, with an incidence of 1.49%. Five of these consults were performed in the ICU. While Recalcati et al. reported an incidence of 20.4% skin manifestations, 4 our data are more similar to those described by Chinese colleagues (1.2%). 5 No statistically significant differences in sex and mortality rate were found between the population with dermatological involvement and the main unaffected group. However, hospitalized patients without cutaneous signs were older and had a mean hospitalization time of about 2 weeks, while patients affected by cutaneous manifestations were generally younger, with almost double the time spent in hospital (Fig. 1) . We suggest that the longer hospital stay could be related to a more severe disease course but cannot exclude that the longer period may also be related to a delay in the resolution of the skin signs necessary for discharge. Further data are needed to achieve a reasonable answer. This analysis was limited by the small number of patients considered as well as the presence of many confounding factors such as comorbidities and polytherapy drug regimen, which cannot be totally excluded from differential diagnosis. Finally, diagnosis was difficult to address due to the nonspecific clinical patterns shown and described in the literature on these patients. 

A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)

COVID-19: how it can look on the skin. Clinical and pathological features in 20 COVID-19 patients observed in Bologna

Mucosal involvement in a COVID-19-positive patient: a case report

Cutaneous manifestations in COVID-19: a first perspective

Clinical characteristics of coronavirus disease 2019 in China

Funding source: None. doi: 10.1111/ijd.15509