.: ORİJİNAL ARAŞTIRMA
Cutaneous Findings of COVID-19 Infection Related with Length of Hospital Stay: A Prospective, Multicenter Study
COVID-19 Enfeksiyonunun Hastanede Yatış Süresiyle İlişkili Kutanöz Bulguları: Prospektif, Çok Merkezli Çalışma
Turkiye Klinikleri J Dermatol. 2022;32(1):56-61
doi: 10.5336/dermato.2021-86767
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: Coronavirus disease-2019 (COVID-19) was declared a pandemic in March 2020. As the number of cases increased, the infection emerged as a multi-systemic disease. Respiratory, cardiac, hepatic, urinary, circulatory, gastrointestinal systems and finally skin may be the target organs of COVID-19. The aim of this study was to evaluate the cutaneous signs of COVID-19 and their effect on the patients' prognosis. Material and Methods: A total of 192 hospitalized COVID-19 cases, between May 2021 to July 2021 were included in the study. The length of stay (LoS) of the patients were recorded. Hospitalization and discharge decisions and all treatments of the patients were determined at the discretion of the treating physician according to the pandemic guidelines of the Ministry of Health. Fever, fatigue, cough, dyspnea, myalgia, anosmia, and headache were considered COVID-19 symptoms. Results: Dermatological manifestations were seen in 10 cases. LoS in the group with dermatological findings was shorter than the group without dermatological findings and the difference was statistically significant between the groups. Discharge of the patients was the endpoint of the study. Conclusion: Our multicenter study suggests that patients with cutaneous findings usually do not have classical symptoms for COVID-19 and have a shorter LoS.
Keywords: COVID-19; dermatology; length of stay; pandemics; prognosis
Objective: Coronavirus disease-2019 (COVID-19) was declared a pandemic in March 2020. As the number of cases increased, the infection emerged as a multi-systemic disease. Respiratory, cardiac, hepatic, urinary, circulatory, gastrointestinal systems and finally skin may be the target organs of COVID-19. The aim of this study was to evaluate the cutaneous signs of COVID-19 and their effect on the patients' prognosis. Material and Methods: A total of 192 hospitalized COVID-19 cases, between May 2021 to July 2021 were included in the study. The length of stay (LoS) of the patients were recorded. Hospitalization and discharge decisions and all treatments of the patients were determined at the discretion of the treating physician according to the pandemic guidelines of the Ministry of Health. Fever, fatigue, cough, dyspnea, myalgia, anosmia, and headache were considered COVID-19 symptoms. Results: Dermatological manifestations were seen in 10 cases. LoS in the group with dermatological findings was shorter than the group without dermatological findings and the difference was statistically significant between the groups. Discharge of the patients was the endpoint of the study. Conclusion: Our multicenter study suggests that patients with cutaneous findings usually do not have classical symptoms for COVID-19 and have a shorter LoS.
Keywords: COVID-19; dermatology; length of stay; pandemics; prognosis
ÖZET
Amaç: Koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)], Mart 2020 tarihinde pandemi ilan edildi. Vaka sayısı arttıkça enfeksiyon multisistemik bir hastalık olarak gözlemlenmeye başlandı. Solunum, kardiyak, hepatit, renal, vasküler, gastrointestinal sistemler ve son olarak deri, COVID-19'un hedef organları olabilmektedir. Bu çalışmanın amacı, COVID-19'un kutanöz belirtilerini ve bunların hasta prognozu üzerindeki etkisini değerlendirmektir. Gereç ve Yöntemler: Mayıs-Temmuz 2021 tarihleri arasında hastanede yatan toplam 192 COVID-19 vakası çalışmaya dâhil edildi. Hastaların, hastanede kalış süreleri [length of stay (LoS)] kaydedildi. Hastaların yatış ve taburculuk kararları ve tüm tedavileri, Sağlık Bakanlığının pandemi kılavuzlarına göre tedaviyi yapan hekimin inisiyatifinde belirlendi. Ateş, yorgunluk, öksürük, nefes darlığı, miyalji, anosmi ve baş ağrısı, COVID-19 semptomları olarak kabul edildi. Bulgular: On olguda dermatolojik bulgular görüldü. Dermatolojik bulgusu olan gruptaki LoS, dermatolojik bulgusu olmayan gruba göre daha kısaydı ve gruplar arasındaki fark istatistiksel olarak anlamlıydı. Hastaların taburcu edilmesi çalışmanın bitiş noktasıydı. Sonuç: Çok merkezli çalışmamız, kutanöz bulguları olan hastaların genellikle COVID-19 için klasik semptomlarının olmadığını ve daha kısa bir LoS'a sahip olduğunu göstermektedir.
Anahtar Kelimeler: COVID-19; dermatoloji; yatış süresi; pandemik; prognoz
Amaç: Koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)], Mart 2020 tarihinde pandemi ilan edildi. Vaka sayısı arttıkça enfeksiyon multisistemik bir hastalık olarak gözlemlenmeye başlandı. Solunum, kardiyak, hepatit, renal, vasküler, gastrointestinal sistemler ve son olarak deri, COVID-19'un hedef organları olabilmektedir. Bu çalışmanın amacı, COVID-19'un kutanöz belirtilerini ve bunların hasta prognozu üzerindeki etkisini değerlendirmektir. Gereç ve Yöntemler: Mayıs-Temmuz 2021 tarihleri arasında hastanede yatan toplam 192 COVID-19 vakası çalışmaya dâhil edildi. Hastaların, hastanede kalış süreleri [length of stay (LoS)] kaydedildi. Hastaların yatış ve taburculuk kararları ve tüm tedavileri, Sağlık Bakanlığının pandemi kılavuzlarına göre tedaviyi yapan hekimin inisiyatifinde belirlendi. Ateş, yorgunluk, öksürük, nefes darlığı, miyalji, anosmi ve baş ağrısı, COVID-19 semptomları olarak kabul edildi. Bulgular: On olguda dermatolojik bulgular görüldü. Dermatolojik bulgusu olan gruptaki LoS, dermatolojik bulgusu olmayan gruba göre daha kısaydı ve gruplar arasındaki fark istatistiksel olarak anlamlıydı. Hastaların taburcu edilmesi çalışmanın bitiş noktasıydı. Sonuç: Çok merkezli çalışmamız, kutanöz bulguları olan hastaların genellikle COVID-19 için klasik semptomlarının olmadığını ve daha kısa bir LoS'a sahip olduğunu göstermektedir.
Anahtar Kelimeler: COVID-19; dermatoloji; yatış süresi; pandemik; prognoz
REFERANSLAR:
- Zhao Q, Fang X, Pang Z, Zhang B, Liu H, Zhang F. COVID-19 and cutaneous manifestations: a systematic review. J Eur Acad Dermatol Venereol. 2020;34(11):2505-10. [Crossref] [PubMed] [PMC]
- Marzano AV, Cassano N, Genovese G, Moltrasio C, Vena GA. Cutaneous manifestations in patients with COVID-19: a preliminary review of an emerging issue. Br J Dermatol. 2020; 183(3):431-42. [Crossref] [PubMed] [PMC]
- Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al; China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-33. [Crossref] [PubMed] [PMC]
- Giavedoni P, Podlipnik S, Pericàs JM, Fuertes de Vega I, García-Herrera A, Alós L, et al. Skin manifestations in COVID-19: prevalence and relationship with disease severity. J Clin Med. 2020;9(10):3261. [Crossref] [PubMed] [PMC]
- Wollina U, Chiriac A, Karadag AS. The dermatological spectrum of coronavirus disease-19 disease: cutaneous signs for diagnostics and prognosis and an expanded classification. Open Access Maced J Med Sci. 2020;8(T1): 294-303. [Crossref]
- Drenovska K, Schmidt E, Vassileva S. Covid-19 pandemic and the skin. Int J Dermatol. 2020;59(11):1312-9. [Crossref] [PubMed] [PMC]
- Freeman EE, McMahon DE, Lipoff JB, Rosenbach M, Kovarik C, Desai SR, et al. The spectrum of COVID-19-associated dermatologic manifestations: An international registry of 716 patients from 31 countries. J Am Acad Dermatol. 2020;83(4):1118-29. [Crossref] [PubMed] [PMC]
- Rees EM, Nightingale ES, Jafari Y, Waterlow NR, Clifford S, B Pearson CA, et al. COVID-19 length of hospital stay: a systematic review and data synthesis. BMC Med. 2020;18(1): 270. [Crossref] [PubMed] [PMC]
- Gül Ü. COVID-19 and dermatology. Turk J Med Sci. 2020;50(8):1751-9. [Crossref] [PubMed] [PMC]
- Galván Casas C, Català A, Carretero Hernández G, Rodríguez-Jiménez P, Fernández-Nieto D, Rodríguez-Villa Lario A, et al. Class ification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases. Br J Dermatol. 2020;183(1):71-7. [Crossref] [PubMed] [PMC]
- Algaadi SA. Urticaria and COVID-19: a review. Dermatol Ther. 2020;33(6):e14290. [Crossref] [PubMed]
- Imbalzano E, Casciaro M, Quartuccio S, Minciullo PL, Cascio A, Calapai G, et al. Association between urticaria and virus infections: a systematic review. Allergy Asthma Proc. 2016;37(1):18-22. [Crossref] [PubMed]
- Zhang JJ, Dong X, Cao YY, Yuan YD, Yang YB, Yan YQ, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020;75(7):1730-41. [Crossref] [PubMed]
- Dastoli S, Bennardo L, Patruno C, Nisticò SP. Are erythema multiforme and urticaria related to a better outcome of COVID-19? Dermatol Ther. 2020;33(4):e13681. [Crossref] [PubMed] [PMC]
- Elsaie ML, Youssef EA, Nada HA. Herpes zoster might be an indicator for latent COVID 19 infection. Dermatol Ther. 2020;33(4): e13666. [Crossref] [PubMed] [PMC]
- Llamas-Velasco M, Rodríguez-Jiménez P, Chicharro P, De Argila D, Mu-oz-Hernández P, Daudén E. Reply to "Varicella-like exanthem as a specific COVID-19-associated skin manifestation: Multicenter case series of 22 patients": To consider varicella-like exanthem associated with COVID-19, virus varicella zoster and virus herpes simplex must be ruled out. J Am Acad Dermatol. 2020;83(3):e253-4. [Crossref] [PubMed] [PMC]
- Thai PQ, Toan DTT, Son DT, Van HTH, Minh LN, Hung LX, et al. Factors associated with the duration of hospitalisation among COVID-19 patients in Vietnam: a survival analysis. Epidemiol Infect. 2020;148:e114. [Crossref] [PubMed] [PMC]
- Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9. Erratum in: JAMA. 2021;325(11):1113. [Crossref] [PubMed] [PMC]
- Lescure FX, Bouadma L, Nguyen D, Parisey M, Wicky PH, Behillil S, et al. Clinical and virological data of the first cases of COVID-19 in Europe: a case series. Lancet Infect Dis. 2020;20(6):697-706. Erratum in: Lancet Infect Dis. 2020. Erratum in: Lancet Infect Dis. 2020;20(6):e116. [Crossref] [PubMed] [PMC]
- CDC COVID-19 Response Team. Severe outcomes among patients with coronavirus disease 2019 (COVID-19) - United States, February 12-March 16, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(12):343-6. [Crossref] [PubMed] [PMC]
- Wu S, Xue L, Legido-Quigley H, Khan M, Wu H, Peng X, et al. Understanding factors influencing the length of hospital stay among non-severe COVID-19 patients: a retrospective cohort study in a Fangcang shelter hospital. PLoS One. 2020;15(10):e0240959. [Crossref] [PubMed] [PMC]
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