COVID-19 and Cutaneous Disorders: What’s Being Reported? A Meta-Analysis from Observational Studies and Case Reports

Abstract

Background: Coronavirus disease (COVID-19) is related to several extrapulmonary disorders; however, little is known about the skin disorders characteristics and prevalence. Objetive: Summarize and evaluate the skin disorders’ characteristics and prevalence reported in the literature. Methods: We conducted a search on PubMed, SciELO and ScienceDirect between 01/01/2020 to 09/28/2020. The target population was patients with skin disorder and a positive diagnosis for COVID-19. All observational studies, research letters, case series and case reports were selected. We evaluated observational studies using Random- effects models to calculate the weighted mean prevalence and 95% confidence interval (CI). We evaluated the case studies using the chi-square test for dichotomous variables and the Mann-Whitney test for continuous variables. Results: Eighty-seven patients from case reports and six observational studies with 363 patients were selected. Eleven types of skin disorders in COVID-19 confirmed patients are described. Skin disorder weighted mean prevalence was 9.9% (95% CI: 3.7-24.1). Maculopapular rash was the most prevalent disorder (37.5%; 95% CI: 21-57%). Latency was significantly lower in patients over 60 years old (p=0.041). Conclusion: Each cutaneous manifestation has its particularities and may or may not accompany other signs and symptoms. It is possible for the elderly to have COVID-19- related skin disorders early.