Page 22 - Florida Sentinel 1-21-22

Health
Ever since this COVID-19 pandemic started, there have been a number of reports of the symptoms you should look for if you think you have it. You’re most likely aware of the common symptoms:
– Cough
– Shortness of breath or difficulty breathing
– Chills
– Fever
– Muscle pain
– New loss of taste or smell – Sore throat
There are also less com- mon symptoms that are re- ported like nausea, vomiting or diarrhea. But have you heard of “COVID toes?”
Infectious disease experts suggest that “COVID toes” might be the result of the body’s inflammatory response being focused on the foot and toes.
The lesions also could be tied to the clotting of blood vessels in these extremities. But there are no clear an-
swers.
What patients are experi-
encing are red or purple bumps on their toes or hands, as well as a burning sensation, often with pain and tender- ness. It seems to go away after about 2-3 weeks.
Similar lesions also occur in other types of viral infec- tions, particularly viral respi- ratory infections that lead to ARDS.
Many of the cases involv- ing so-called “COVID toes” have been in children and young adults. Dr. Robin Gehris, division chief of pedi- atric dermatology at UPMC Children’s Hospital of Pitts- burgh has documented about 30 cases of “COVID toes” in children, teens and young adults under 26.
Many of them had symp- toms similar to COVID-19 sev- eral weeks before their toe lesions appeared. “COVID toes” appeared as red or pur- ple lesions that were tender, itchy or both.
“Patients with ‘COVID toes’ seem to be healthy when it presents and we wonder if they could be in the process of mounting an antibody re- sponse to the virus with sec- ondary inflammation,” Gehris said.
While COVID toes and rashes have been associated with the coronavirus more than other viral infections, Pulmonologist Dr. Hum- berto Choi explains that these symptoms haven’t been widespread so far.
“These symptoms seem to be more common in COVID- 19 compared with all other viral infections,” says Dr. Choi. “But at this time, they haven’t affected a majority of people. So, the symptoms that people should be looking for are really a fever, cough and muscle aches that you can get when you have a viral infec- tion.
Those are the most com- mon symptoms — and those are the things that people
should be keeping on their radar.”
Dermatology experts say one of the challenges around these lesions is that the knowl- edge is continuing to evolve around how they counsel pa- tients regarding quarantine at this time. People should be following CDC and local guidelines in terms of self-iso- lating, regardless. We know that some patients who de- velop the pernio-like lesions of their feet are still infectious, because they are testing PCR positive for the virus.
This means that there is a potential risk of transmitting the virus to others. It seems that some people may develop these lesions while they are still infectious, while others may develop them somewhat later in the disease course. We need more data on the timing of these pernio-like lesions so we can better guide our providers on how to counsel their patients. That is an area we are actively working on.
This has public health im- plications because if your pa- tient is potentially still infectious when their toes are purple, that is a different story than if they are not infectious and they are already basically over the infectious stage of the virus.
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