Cutaneous manifestations of COVID-19 in patients hospitalized in a university hospital in Rio de Janeiro: descriptive study
DOI:
https://doi.org/10.33448/rsd-v12i4.40898Keywords:
Skin; COVID-19; Nursing; Wounds; Injuries.Abstract
Introduction: The coronavirus is an infectious disease, which in its classic presentation causes a viral infection followed by pulmonary and systemic inflammation, being observed in some patients in addition to respiratory symptoms, cutaneous manifestations. The severity and complexity of the patients also determined inevitable pressure injuries (PL), being relevant differential diagnosis of injuries secondary to COVID-19, especially livedoid and purpuric. Objective: to identify the cutaneous manifestations found in the medical records of patients with COVID-19; describe the profile of patients affected by cutaneous manifestations related to COVID-19; to determine the incidence rate of these skin lesions in the analyzed population and to describe the main preventive care for the prevention of skin lesions. Method: documentary, retrospective, quantitative study, which took place between September 2021 and November 2022 at a university hospital in Rio de Janeiro. Results: 596 patients analyzed, 98 of them with 155 diagnosed skin lesions: 15 secondary to COVID-19 - 09 (5.80%) livedoid, 03 (1.93%) cyanosis and 03 (1.93%) purpuric lesions , in addition to 111 (71.61%) LP and 29 (18.70%) mixed lesions. PI had an incidence of 18.62%, followed by mixed injuries, with a rate of 4.86%, and injuries secondary to COVID-19, with 2.51%. Conclusion: COVID-19-related injuries were less frequent than PI, confirming the inevitability referred to by the NPIAP. Therefore, more epidemiological studies are needed. Regarding skin care, basic measures to maintain its integrity must respect good hygiene and hydration practices.
References
Black, J., Cuddigan, J. and members of the Board of Directors of the National Pressure Injury Advisory Panel. (2020a) . Skin manifestations with COVID-19: The purple skin and toes you are seeing may not be a deep tissue pressure injury. An NPIAP White Paper.
Black, J., Cuddigan, J., Capasso, V., Cox, J., Delmore, B., Munoz, N., & Pittman, J. (2020b) On behalf of the National Pressure Injury Advisory Panel. Unavoidable Pressure Injury during COVID-19 Crisis: A Position Paper from the National Pressure Injury Advisory Panel.
Cardinelli, C .C.; Santos, H. C. N. ; Di Piero, K. C. ; Santos, R. P. (2022) Cuidados Preventivos de Enfermagem com a pele do paciente acamado durante o processo de hospitalização. In: Francisca Georgina Macedo de Sousa; Andréa Cristina Oliveira Silva. (Org.). CUIDADO DE ENFERMAGEM EM AMBIENTE HOSPITALAR: recursos éticos, gerenciais e assistenciais. 1ed. Curitiba: CRV, 2022, v. 1, p. 267-285.
Casas, C. G., Català, A., Carretero Hernández, G., Rodríguez-Jiménez, P., Fernández-Nieto, D., Rodríguez-Villa Lario, A., Navarro Fernández, I., Ruiz-Villaverde, R., Falkenhain-López, D., Llamas Velasco, M., García-Gavín, J., Baniandrés, O., González-Cruz, C., Morillas-Lahuerta, V., Cubiró, X., Figueras Nart, I., Selda-Enriquez, G., Romaní, J., Fustà-Novell, X., Melian-Olivera, A., … García-Doval, I. (2020). Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases. The British journal of dermatology, 183(1), 71–77.
European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance. (2019) Prevenção e tratamento de lesões / úlceras por pressão. Guía de consulta rápida. (edição Portuguesa).
Freeman, E. E., McMahon, D. E., Lipoff, J. B., Rosenbach, M., Kovarik, C., Desai, S. R., Harp, J., Takeshita, J., French, L. E., Lim, H. W., Thiers, B. H., Hruza, G. J., & Fox, L. P. (2020). The spectrum of COVID-19-associated dermatologic manifestations: An international registry of 716 patients from 31 countries. Journal of the American Academy of Dermatology, 83(4), 1118–1129.
Gupta, A., Madhavan, M. V., Sehgal, K., Nair, N., Mahajan, S., Sehrawat, T. S., Bikdeli, B., Ahluwalia, N., Ausiello, J. C., Wan, E. Y., Freedberg, D. E., Kirtane, A. J., Parikh, S. A., Maurer, M. S., Nordvig, A. S., Accili, D., Bathon, J. M., Mohan, S., Bauer, K. A., Leon, M. B., … Landry, D. W. (2020). Extrapulmonary manifestations of COVID-19. Nature medicine, 26(7), 1017–1032.
Irigoyen, A. G., Acatitla-Acevedo, G. A., Barrera-Godínez, A., Méndez-Flores, S., & Domínguez-Cherit, J. (2021). Follow-up of dermatological manifestations in non-critical hospitalized patients with COVID-19 pneumonia and their prognostic correlation with disease severity. Journal of the European Academy of Dermatology and Venereology : JEADV, 35(7), e421–e423.
Joob, B., & Wiwanitkit, V. (2020). COVID-19 can present with a rash and be mistaken for dengue. Journal of the American Academy of Dermatology, 82(5), e177.
Le Cleach L. (2021). Dermatology and COVID-19: Much knowledge to date but still a lot to discover. Annales de dermatologie et de venereologie, 148(2), 69–70.
Loganathan, S., Kuppusamy, M., Wankhar, W., Gurugubelli, K. R., Mahadevappa, V. H., Lepcha, L., & Choudhary, A. K. (2021). Angiotensin-converting enzyme 2 (ACE2): COVID 19 gate way to multiple organ failure syndromes. Respiratory physiology & neurobiology, 283, 103548.
Medeiros, E. A. S.. (2020). CHALLENGES IN THE FIGHT AGAINST THE COVID-19 PANDEMIC IN UNIVERSITY HOSPITALS. Revista Paulista De Pediatria, 38(Rev. paul. pediatr., 2020 38), e2020086.
Medronho R. A. (2005) Epidemiologia. São Paulo: Atheneu.
Recalcati S. (2020). Cutaneous manifestations in COVID-19: a first perspective. Journal of the European Academy of Dermatology and Venereology : JEADV, 34(5), e212–e213.
Rezende D. A., L., de Souza Silva Freitas, P., de Jesus Silva, K. E., de Souza Catabriga, D., Araújo dos Santos, R., Nogueira, P. C., Caniçali Primo, C., & de Oliveira Ramalho, A. (2022). Lesões por pressão e os desafios frente à pandemia de COVID-19. Revista Enfermagem Atual In Derme, 96(38), e–021253.
Ring J. (2020). COVID-19 and its implications for Dermatology and Venereology. Journal of the European Academy of Dermatology and Venereology : JEADV, 34(5), 914.
Seque, C. A., Enokihara, M. M. S. e S., Porro, A. M., & Tomimori, J.. (2022). Skin manifestations associated with COVID-19. Anais Brasileiros De Dermatologia, 97(An. Bras. Dermatol., 2022 97(1)), 75–88.
Sousa Neto, A. R. de ., Carvalho, A. R. B. de ., Oliveira, E. M. N. de ., Magalhães, R. de L. B., Moura, M. E. B., & Freitas, D. R. J. de .. (2021). Symptomatic manifestations of the disease caused by coronavirus (COVID-19) in adults: systematic review. Revista Gaúcha De Enfermagem, 42(Rev. Gaúcha Enferm., 2021 42(spe)).
Sousa B. C. de, Rodrigues F. O. S., & Vasconcelos H. G. (2021). Manifestações dermatológicas em pacientes com COVID-19: uma revisão epidemiológica da literatura nacional. Revista Eletrônica Acervo Científico, 23, e7141.
Wu, D., Wu, T., Liu, Q., & Yang, Z. (2020). The SARS-CoV-2 outbreak: What we know. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 94, 44–48.
Wu, Z., & McGoogan, J. M. (2020). Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA, 323(13), 1239–1242.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Isadora Castelletti Massapust Medeiros; Yannky Alberto López; Camila Castanho Cardinelli; Karina Chamma Di Piero
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
