Publication Date
2020
Journal Title
J Am Acad Dermatol
Abstract
Background
Little is known about mucocutaneous disease in acutely ill children and adolescents with COVID-19 and multisystem inflammatory syndrome in children (MIS-C).
Objective
To characterize mucocutaneous disease and its relation to clinical course among hospitalized patients with COVID-19 and MIS-C.
Methods
Descriptive cohort study of prospectively and consecutively hospitalized eligible patients between May 11, 2020 and June 5, 2020.
Results
In COVID-19 patients, 4 of 12 (33%) had rash and/or mucositis, including erythema, morbilliform pattern, and lip mucositis. In MIS-C patients, 9 of 19 (47%) had rash and/or mucositis, including erythema, morbilliform, retiform purpura, targetoid and urticarial patterns, along with acral edema, lip mucositis, tongue papillitis, and conjunctivitis. COVID-19 patients with rash had less frequent respiratory symptoms, pediatric intensive care unit admission, invasive ventilation, and shorter stay versus COVID-19 patients without rash. MIS-C patients with rash had less frequent pediatric intensive care unit admission, shock, ventilation, as well as lower levels of C-reactive protein, ferritin, D-dimer, and troponin (vs MIS-C without rash). Neutrophil-to-lymphocyte ratio was similar for patients with and without rash in both groups. None of the MIS-C patients met criteria for Kawasaki disease.
Limitations
Small sample sizes.
Conclusions
Mucocutaneous disease is common among children and adolescents with COVID-19 and MIS-C. Laboratory trends observed in patients with rash may prognosticate a less severe course.
Volume Number
84
Issue Number
2
Pages
408-414
Document Type
Article
Status
Faculty; Northwell Researcher; Northwell Resident; SOM Student
Facility
School of Medicine; Northwell Health
Primary Department
Dermatology
Additional Departments
COVID-19 Publications
PMID
DOI
10.1016/j.jaad.2020.10.060