Background

SARS-Cov-2 is a single-stranded RNA virus, a Betacoronavirus, composed of 16 non-structural proteins, with specific roles in replication of coronaviruses. The pathogenesis of COVID-19 is not yet fully understood. The virus and host factors interplay among distinct outcomes of infected patients.

Methods

Using MeSH (Medical Subject Headings) in PubMed, authors searched for articles cotaining information on COVID-19 and the skin.

Results

The pathophysiology of the disease is multifactorial: association with innate immune response, hypercoagulability state, lung tissue damage, neurological and/or gastrointestinal tract involvement, monocytic/macrophage activation syndrome, culminating in exaggerated cytokine secretion, called “cytokine storm”, which leads to worsening and death. These systemic conditions may be associated with cutaneous lesions, that have polymorphic aspects, where at histopathological level show involvement in different skin changes. These lesions may be associated with multisystemic manifestations that could occur due to angiotensin-converting enzyme 2 receptor and transmembrane serine protease action, allowing the pulmonary infection and possibly skin manifestation. Several reports in literature show cutaneous lesions similar to chilblain, urticarial eruptions, diffuse or disseminated erythema, livedo racemosa, blue toe syndrome, retiform purpura, vesicle trunk, purpuric exanthema or exanthema with clinical aspects of symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) and others.

Conclusions

This review describes the complexity of Covid-19, pathophysiological and clinical aspects, dermatological finding and other dermatological conditions associated with SARS-CoV-2 infection or COVID-19.

中文翻译：

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SARS-CoV-2 感染/COVID-19 期间或引起的皮肤表现是否频繁？修改可能的病理生理机制。

 背景

SARS-Cov-2是一种单链RNA病毒，即β冠状病毒，由16种非结构蛋白组成，在冠状病毒的复制中具有特定作用。 COVID-19 的发病机制尚未完全清楚。病毒和宿主因素在感染患者的不同结果中相互作用。

 方法

作者使用 PubMed 中的 MeSH（医学主题词）搜索包含有关 COVID-19 和皮肤信息的文章。

 结果

该疾病的病理生理学是多因素的：与先天免疫反应、高凝状态、肺组织损伤、神经和/或胃肠道受累、单核细胞/巨噬细胞激活综合征有关，最终导致细胞因子过度分泌，称为“细胞因子风暴”，从而导致病情恶化和死亡。这些全身性疾病可能与具有多态性方面的皮肤病变有关，在组织病理学水平上显示涉及不同的皮肤变化。这些病变可能与血管紧张素转换酶 2 受体和跨膜丝氨酸蛋白酶作用引起的多系统表现相关，从而导致肺部感染和可能的皮肤表现。文献中的一些报告显示，皮肤病变类似于冻疮、荨麻疹、弥漫性或播散性红斑、葡萄状青斑、蓝趾综合征、网状紫癜、水疱干、紫癜性皮疹或伴有对称性药物相关间擦和弯曲皮疹临床表现的皮损（SDRIFE） ）和其他。

 结论

本综述描述了 Covid-19 的复杂性、病理生理学和临床方面、皮肤病学发现以及与 SARS-CoV-2 感染或 COVID-19 相关的其他皮肤病状况。