Abstract
Background: The microbiological diagnosis of skin lesions related to COVID-19 is not well known.
Objective: Perform a microbiological diagnosis in COVID19-related cutaneous manifestations.
Methods: A cross-sectional study was performed with 64 patients with cutaneous manifestations associated with COVID-19 who underwent serological and nasopharyngeal reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2.
Results: Out of the 64 patients, 6 patients had positive RT-PCR, with all of them developing SARS-CoV-2 IgG and 4 of them had positive IgM + IgA. Of the 58 patients with negative RT-PCR, 8 cases had positive IgM + IgA and only one of them had IgG seroconversion. Therefore, the infection was demonstrated in 7 cases (10.9%) and was doubtful in 7 other cases (10.9%) who presented negative RT-PCR and presence of IgA + IgM without subsequent seroconversion of IgG. Fifty patients (78.1%) had negative serological tests. The most frequent cutaneous pattern was pseudo-chilblain (48.4%) followed by maculo-papular pattern (26.6%), urticarial lesions (10.9%), vesicular eruptions (6.3%) and livedoid pattern (4.7%). The maculo-papular pattern showed the highest positivity in RT-PCR (3 cases; 17.6%) and serologies (4 cases; 23.5%). Skin lesions developed after the systemic symptoms in most patients (19 cases; 61.3%).
Conclusions: Microbiological confirmation tests may not be an effective diagnostic technique for COVID-related cutaneous manifestations or that attributed lesions are not related to COVID-19. Confounding factors such as adverse drug reaction, serological cross-reactions with other viruses, the low production of antibodies in asymptomatic or mild forms of COVID-19 or its rapid disappearance, increase diagnostic uncertainty.
Keywords: COVID-19; RT-PCR; SARS-CoV-2; cutaneous manifestations; serological test.
【저자키워드】 COVID-19, serological test, SARS-CoV-2, RT-PCR, Cutaneous manifestations, 【초록키워드】 viruses, serological test, IgG, IgM, serology, antibody, cross-sectional, Infection, diagnostic, Diagnosis, Seroconversion, Asymptomatic, IgA, nasopharyngeal, Patient, Mild, reverse transcription, serological, patients, SARS-CoV-2 IgG, positive RT-PCR, cutaneous manifestation, livedoid, lesion, Factor, skin lesion, positive, negative RT-PCR, effective, polymerase chain, highest, subsequent, form, was performed, demonstrated, Confounding, serological cross-reaction, systemic symptom, with COVID-19, 【제목키워드】 Antibody Response, cutaneous manifestation,