Table III.
COVID-19–related characteristics of patients with laboratory-confirmed COVID-19 and new-onset dermatologic conditions
| Characteristics | Laboratory-confirmed COVID-19 |
||||||
|---|---|---|---|---|---|---|---|
| Morbilliform (n = 38)∗ | Pernio (n = 31) | Urticarial (n = 27) | Macular erythema (n = 23) | Vesicular (n = 18) | Papulosquamous (n = 17) | Retiform purpura (n = 11) | |
| COVID-19 diagnosis, n (%) | |||||||
| PCR | 32 (84) | 16 (52) | 23 (85) | 19 (83) | 16 (89) | 14 (82) | 10 (91) |
| Antibody | — | 11 (35)† | — | 2 (8.7) | 1 (5.5) | 3 (18) | — |
| Unspecified laboratory assay | 6 (16) | 4 (13) | 4 (15) | 2 (8.7) | 1 (5.5) | — | 1 (9) |
| COVID-19 exposure, n (%) | |||||||
| None | 9 (24) | 11 (36) | 9 (33) | 7 (30) | 4 (22) | 6 (35) | 6 (55) |
| Unknown | 13 (34) | 7 (23) | 6 (22) | 5 (22) | 5 (28) | 4 (24) | 3 (27) |
| Close contact with a laboratory-confirmed case of COVID-19 infection | 9 (24) | 5 (16) | 7 (26) | 7 (30) | 3 (17) | 4 (24) | 1 (9.1) |
| Close contact with a probable case of COVID-19 infection | 5 (13) | 7 (23) | 4 (15) | 3 (13) | 3 (17) | 3 (18) | — |
| Presence in a health care facility where COVID-19 infections have been managed | 8 (21) | 1 (3.2) | 5 (19) | 2 (8.7) | 3 (17) | 1 (5.9) | 1 (9.1) |
| COVID-19 symptoms, n (%) | |||||||
| Fever | 28 (74) | 11 (35) | 19 (70) | 15 (65) | 13 (72) | 10 (59) | 7 (64) |
| Cough | 25 (66) | 11 (35) | 16 (59) | 12 (52) | 11 (61) | 9 (53) | 8 (73) |
| Shortness of breath | 17 (45) | 9 (29) | 11 (41) | 9 (39) | 5 (28) | 5 (29) | 8 (73) |
| Sore throat | 15 (40) | 8 (26) | 11 (41) | 9 (39) | 9 (50) | 7 (41) | 3 (27) |
| Headache | 14 (37) | 7 (23) | 13 (48) | 7 (30) | 6 (33) | 7 (41) | — |
| Diarrhea, vomiting, or nausea | 15 (40) | 7 (23) | 10 (37) | 9 (39) | 5 (28) | 5 (29) | — |
| Malaise | 12 (32) | 5 (16) | 8 (30) | 9 (39) | 6 (33) | 2 (12) | 3 (27) |
| Myalgia | 8 (21) | 10 (32) | 9 (33) | 2 (8.7) | 4 (22) | 2 (12) | — |
| Irritability/confusion | 5 (13) | 3 (9.7) | 5 (19) | 4 (17) | 6 (33) | 4 (24) | — |
| Chest pain | 2 (5.3) | 2 (6.5) | 7 (26) | 5 (22) | 4 (22) | 5 (29) | — |
| Abdominal pain | 1 (2.6) | 1 (3.2) | 7 (26) | 5 (22) | 5 (28) | 4 (24) | — |
| Anosmia | 3 (7.9) | 3 (9.7) | 2 (7.4) | 3 (13) | 5 (28) | 2 (12) | — |
| Dysgeusia | 1 (2.6) | 2 (6.5) | 5 (19) | — | 2 (11) | 2 (12) | — |
| Arthralgia | 7 (18) | 1 (3.2) | 3 (11) | 1 (4.3) | 3 (17) | — | 1 (9.1) |
| Rhinorrhea | 3 (7.9) | 5 (16) | 4 (15) | 1 (4.3) | 1 (5.6) | — | — |
| Asymptomatic | 1 (2.6) | 6 (19) | 2 (7.4) | — | — | 2 (12) | — |
| COVID-19 testing criteria, n (%)‡ | |||||||
| Does not meet CDC testing criteria | 2 (5.3) | 9 (29) | 2 (7.4) | 1 (4.3) | — | 2 (12) | — |
| 1 or 2 CDC testing criteria | 15 (40) | 13 (42) | 6 (22) | 5 (22) | 7 (39) | 8 (47) | 6 (55) |
| 3 or more CDC testing criteria | 21 (55) | 9 (29) | 19 (70) | 17 (74) | 11 (61) | 7 (41) | 5 (46) |
| COVID-19 treatment, n (%) | |||||||
| Supportive care only | 19 (50) | 21 (68) | 16 (59) | 14 (61) | 11 (61) | 15 (88) | — |
| Antimalarial agents | 13 (34) | 3 (9.7) | 6 (22) | 4 (17) | 4 (22) | 1 (5.9) | 10 (91) |
| Antibiotics | 11 (29) | 4 (13) | 6 (22) | 6 (26) | 4 (22) | — | 9 (82) |
| Bevacizumab | 5 (13) | — | 4 (15) | 1 (4.3) | 2 (11) | — | — |
| Remdesivir | 2 (5.3) | 1 (3.2) | 2 (7.4) | 1 (4.3) | 1 (5.6) | 1 (5.9) | 1 (9.1) |
| Serpin inhibitors | 1 (2.6) | 1 (3.2) | 1 (3.7) | — | 1 (5.6) | 2 (12) | — |
| IL-6 inhibitors | — | — | 1 (3.7) | — | 1 (5.6) | — | 2 (18) |
| Lopinavir/ritonavir | 1 (2.6) | — | 1 (3.7) | — | — | — | — |
| JAK inhibitors | — | 2 (6.5) | — | — | — | — | — |
| COVID-19 level of care, n (%) | |||||||
| Outpatient care only | 21 (55) | 26 (84) | 18 (67) | 14 (61) | 14 (78) | 16 (94) | 0 |
| Hospitalized | |||||||
| No supplemental oxygen | 5 (13) | 2 (6.5) | 5 (19) | 1 (4.3) | 3 (17) | 1 (5.9) | 0 |
| Supplemental oxygen only | 6 (16) | — | 2 (7.4) | 4 (17) | — | — | 1 (9.1) |
| Noninvasive ventilation or high flow oxygen | — | 1 (3.2) | 0 | — | — | — | 0 |
| Ventilator and/or ECMO required | 6 (16) | 1 (3.2) | 2 (17.4) | 4 (17) | 1 (5.6) | — | 10 (91) |
| COVID-19 complications, n (%) | |||||||
| None | 27 (71) | 26 (84) | 24 (89) | 17 (74) | 17 (94) | 17 (100) | — |
| ARDS | 4 (11) | 1 (3.2) | 1 (3.7) | 4 (17) | 1 (5.6) | — | 9 (82) |
| Thrombotic event | 3 (7.9) | 2 (6.5) | — | 1 (4.3) | — | — | 7 (64) |
| Other infection | 1 (2.6) | 1 (3.2) | 2 (7.4) | 1 (4.3) | — | — | 6 (55) |
| Sepsis | 4 (11) | — | 0 | 2 (8.7) | — | — | 2 (18) |
| Acute kidney injury | 3 (7.9) | — | — | 2 (8.7) | — | — | 2 (18) |
| Death | 1 (2.6) | 2 (6.5) | 1 (3.7) | 1 (4.4) | — | — | 3 (27) |
| Comorbid medical conditions, n (%) | |||||||
| None | 21 (55) | 21 (68) | 17 (63) | 13 (57) | 12 (67) | 13 (77) | 2 (18) |
| Hypertension | 8 (21) | 4 (13) | 3 (11) | 4 (17) | 3 (17) | 3 (18) | 7 (64) |
| Diabetes | 7 (18) | — | 4 (15) | 1 (4.3) | 2 (11) | 1 (5.9) | 4 (36) |
| Obstructive lung disease | 3 (7.9) | — | 1 (3.7) | 2 (8.7) | 1 (5.6) | 1 (5.9) | 6 (55) |
| Other lung disease | 3 (7.9) | 1 (3.2) | 3 (11) | 1 (4.3) | 1 (5.6) | — | — |
| Rheumatologic disease | 1 (2.6) | 2 (6.5) | — | — | 1 (5.6) | — | 1 (9.1) |
| Cardiovascular disease | 2 (5.3) | 1 (3.2) | — | 1 (4.3) | — | — | 1 (9.1) |
| Kidney disease | 1 (2.6) | — | — | 2 (8.7) | — | 2 (12) | — |
ARDS, Acute respiratory distress syndrome; CDC, Centers for Disease Control and Prevention; ECMO, extracorporeal membrane oxygenation; IL, interleukin; JAK, Janus kinase; PCR, polymerase chain reaction.
∗
Because providers could select more than 1 rash morphology, some patients are double counted (ie, a patient had both morbilliform rash and pernio).
†
Immunoglobulin (Ig) M positive, IgG negative: n = 5; IgM negative, IgG positive: n = 1; IgM unknown, IgG positive: n = 1; unknown type of antibodies tested: n = 4.
‡
CDC testing criteria reviewed as of May 15, 2020, included fever, cough, sore throat, shortness of breath, myalgia, dysgeusia, anosmia, and vomiting/diarrhea.