Incidence and Characterization of Skin Lesions Among Hospitalized Patients with COVID-19 infection: An Observational Cohort Study from Iraq

Abstract

Background and objectives: A wide arrays of skin lesions occurred in the setting of COVID-19 infection. We aimed to estimate the incidence and types of skin lesions among hospitalized patients with COVID-19 infection. Methods: We conducted an observational cohort study on 369 hospitalized patients with COVID-19 infection at Basra Teaching Hospital for 3 months. We studied the incidence and types of skin lesions. Results: Among 369 hospitalized patients, skin lesions were developed in 5%. Of those who developed skin lesions, 33% were asymptomatic. Skin lesions were more frequent in young females (83.3%). The most frequent type of skin lesion was maculopapular 44.3% which occurred exclusively in the medical ward and half of them in asymptomatic patients. For pustular lesions, all were female, diabetic, in the ICU, in symptomatic patients with the highest levels of serum C-reactive proteins. Pseudo-chilblain lesions were reported only in younger female and half of patients were asymptomatic. Urticarial lesions were reported in the younger patients, two-thirds were symptomatic and in the ICU. Purpuric lesions were reported in the older patient who developed acute kidney injury. Extremities were the most common distribution of skin lesions in 38.8%. The mean latency period for development of skin lesions was 8.6 ± 9.1, the shortest for urticarial lesions and the longest for purpuric lesions. Conclusions: Different types of skin lesions were reported in patients with COVID-19 and may be the sole manifestations of the disease.