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Eruptions and related clinical course among 296 hospitalized adults with confirmed COVID-19.

新型冠状病毒肺炎确诊的296例住院成人皮疹和相关临床过程。

  • 影响因子:2.93
  • DOI:10.1016/j.jaad.2020.12.046
  • 作者列表:"Rekhtman S","Tannenbaum R","Strunk A","Birabaharan M","Wright S","Grbic N","Joseph A","Lin SK","Zhang AC","Lee EC","Rivera E","Qiu M","Chelico J","Garg A
  • 发表时间:2021-04-01
Abstract

BACKGROUND:Limited information exists on mucocutaneous disease and its relation to course of COVID-19. OBJECTIVE:To estimate prevalence of mucocutaneous findings, characterize morphologic patterns, and describe relationship to course in hospitalized adults with COVID-19. METHODS:Prospective cohort study at 2 tertiary hospitals (Northwell Health) between May 11, 2020 and June 15, 2020. RESULTS:Among 296 hospitalized adults with COVID-19, 35 (11.8%) had at least 1 disease-related eruption. Patterns included ulcer (13/35, 37.1%), purpura (9/35, 25.7%), necrosis (5/35, 14.3%), nonspecific erythema (4/35, 11.4%), morbilliform eruption (4/35, 11.4%), pernio-like lesions (4/35, 11.4%), and vesicles (1/35, 2.9%). Patterns also showed anatomic site specificity. A greater proportion of patients with mucocutaneous findings used mechanical ventilation (61% vs 30%), used vasopressors (77% vs 33%), initiated dialysis (31% vs 9%), had thrombosis (17% vs 11%), and had in-hospital mortality (34% vs 12%) compared with those without mucocutaneous findings. Patients with mucocutaneous disease were more likely to use mechanical ventilation (adjusted prevalence ratio, 1.98; 95% confidence interval, 1.37-2.86); P < .001). Differences for other outcomes were attenuated after covariate adjustment and did not reach statistical significance. LIMITATIONS:Skin biopsies were not performed. CONCLUSIONS:Distinct mucocutaneous patterns were identified in hospitalized adults with COVID-19. Mucocutaneous disease may be linked to more severe clinical course.

摘要

背景: 关于皮肤黏膜疾病及其与新型冠状病毒肺炎病程的关系的信息有限。 目的: 评估新型冠状病毒肺炎住院成人皮肤黏膜表现的患病率,描述形态模式,并描述与病程的关系。 方法: 在2020年5月11日至20年6月15日期间在2家三级医院 (Northwell Health) 进行前瞻性队列研究。 结果: 在296例新型冠状病毒肺炎的住院成人中,35例 (11.8%) 至少有1例与疾病相关的皮疹。类型包括溃疡 (13/35,37.1%),紫癜 (9/35,25.7%),坏死 (5/35,14.3%),非特异性红斑 (4/35,11.4%),麻疹样疹 (4/35,11.4%),pernio样病变 (4/35,11.4%) 和囊泡 (1/35,2.9%)。模式也显示解剖部位特异性。与无皮肤黏膜检查结果的患者相比,有较高比例的皮肤黏膜检查结果的患者使用机械通气 (61% vs 30%) 、使用血管加压药 (77% vs 33%) 、开始透析 (31% vs 17%) 、血栓形成 (11% vs 34%) 和院内死亡率 (12% vs)。皮肤黏膜疾病患者更倾向于使用机械通气 (校正患病率比,1.98; 95% 可信区间,1.37-2.86; P <.001)。其他结局的差异在协变量调整后减弱,未达到统计学显著性. 局限性: 未进行皮肤活检。 结论: 在新型冠状病毒肺炎的住院成人中发现了不同的皮肤黏膜模式。皮肤粘膜疾病可能与更严重的临床过程有关。

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