Recent studies have suggested that skin rashes are among some of the early signs that you have contracted coronavirus.
The official NHS symptoms are a high temperature, a new and continuous cough and a loss or change to your sense of smell or taste.
However, a range of other symptoms have been identified, with the likes of headaches, muscle and joint pain, nasal congestion, and fatigue frequently seen.
A less common symptom people are now being warned of is various types of rashes, with a recent study finding that for 17 per cent of Covid patients with multiple symptoms, skin rashes were the first symptom to appear, while for 21 per cent of patients rashes were their only symptom.
Here are the four main types of skin changes to look out for, and the possible reasons why they occur.
These are possibly the most well-known. The red, swollen or blistering skin lesions mainly affect the toes and soles of the feet, colloquially known as “COVID toes”.
Over the course of one to two weeks, the lesions will become even more discoloured and will flatten, and after this they will spontaneously resolve without treatment.
A substantial number of these lesions have been seen, primarily in adolescents and young adults with no or only mild symptoms.
They make up the majority of skin issues associated with the virus. In two internationalreports on different types of suspected Covid-related skin conditions, around 60 per cent of patients with skin complaints reported these lesions.
However, given these lesions correlate with mild disease, many of the patients with them in these studies didn’t qualify for a Covid-19 test at the time, and 55 per cent were otherwise asymptomatic.
This means that it has been difficult to directly link the lesions to Covid, despite a swift rise of reports of this nature amid the pandemic.
There a number of theories as to the reasons behind the lesions, which sometimes appear up to 30 days after infection.
It’s suggested that the culprit could be type 1 interferons, proteins that regulate the antiviral properties of the immune system. The high production of these interferons might result in patients rapidly clearing the coronavirus, but also cause injury to blood vessels and increased inflammation.
This would explain the coincidence of mild or nonexistent disease, negative tests and skin damage.
These were associated with more severe symptoms and were mainly found on the trunk in middle-aged to elderly patients. They tended to last 7-18 days, appearing 20-36 days after infection.
It’s suggested this may be caused by the body’s immune system going into overdrive. In some patients, a hyperinflammatory phase occurs 7-10 days after infection, which leads to tissue damage and, potentially, more severe disease and death.
Hives, also known as urticaria, are raised areas of itchy skin. In a study involving four hospitals in China and Italy, 26 per cent of coronavirus complained of skin changes that presented with hives.
Hives typically precede or present at the same time as other symptoms, making them useful for diagnosis. They are more common among middle-aged patients and are associated with more severe disease.
Hives can be triggered by a viral infection, as they cause the breakdown of cells and the release of histamine through a cascade of reactions in the immune system. Though, hives can also be a side-effect of many drugs used to treat Covid, such as corticosteroids and remdesevir.
Much like those seen in cases of chickenpox, these lesions are clear fluid-filled sacs under the skin.
Vesicular lesions are less common when compared to the skin conditions above, with only nine per cent of patients found to have these lesions in the previously mentioned Spanish study.
However, they are thought to be a more specific indication of someone having Covid, when compared to those already listed.
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They appear to present in patients with mild disease around 14 days after infection. and it’s thought that they’re caused by prolonged inflammation, with antibodies attacking the skin and damaging its layers, resulting in fluid-filled sacs.