1887
Volume 2022, Issue 3
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Introduction: Severe acute respiratory syndrome-coronavirus 2 (SARSCoV2) pandemic has been an unceasing plight with a wide range of clinical presentations. The direct effects of the virus, increased use of medications, and lifestyle changes have contributed to the vulnerability to co-infections. Fungal and bacterial co-infections led to increased morbidity and mortality during the pandemic. Similarly, the surge of skin signs in conjunction with herpes zoster (HZ) manifestations has been reported. In this study, we pooled the data on the clinical characteristics of SARS-CoV-2 patients co-infected with HZ.

Methodology: Electronic databases including PubMed, Scopus, and Google Scholar were extensively searched to identify the relevant studies on HZ infection among the SARS-CoV-2 patients.

Results: A total of 79 patients (from case reports, series, and retrospective studies) were included in the analysis. Fever was the most common constitutional symptom recorded, followed by cough and dyspnea. A systemic rash was reported in 78.5% of cases with mild symptoms of HZ and SARS-CoV-2 in 87% and 76%, respectively. Only 19% of the cases presented during the prodrome period of SARS-CoV-2. HZV polymerase chain reaction (PCR) was positive in 8.9% of the cases, and the remaining were diagnosed clinically. SARS-CoV-2 PCR was reported positive in 65 cases (82.3%). Leukopenia was observed in 7 cases (8.9%) and lymphopenia in 25 (31.6%). All patients recovered through conservative treatment.

Conclusion: SARS-CoV-2 escalated the incidence of HZ reactivation. Most of the patients were seen with older individuals either simultaneously or a few days after the SARS-CoV-2 infection, but a few cases were reported during the asymptomatic prodrome period of SARS-CoV-2

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2022.41
2022-09-01
2024-04-20
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2022/3/qmj.2022.41.html?itemId=/content/journals/10.5339/qmj.2022.41&mimeType=html&fmt=ahah

References

  1. WHO. Weekly operational update on COVID-19 - 15 February 2022 2022 [updated 15 February 2022. Available from: https://www.who.int/publications/m/item/weekly-operational-update-on-covid-19–-15-february-2022. 1st May, 2022
  2. Johnson KD, Harris C, Cain JK, Hummer C, Goyal H, Perisetti A. Pulmonary and Extra-Pulmonary Clinical Manifestations of COVID-19. Front Med (Lausanne). 2020;7:526.
    [Google Scholar]
  3. Ng SL, Ong YS, Khaw KY, Teh SP, Tan CS, Ming LC et al.  Focused Review: Potential Rare and Atypical Symptoms as Indicator for Targeted COVID-19 Screening. Medicina (Kaunas). 2021; 57:(2).
    [Google Scholar]
  4. Daneshgaran G, Dubin DP, Gould DJ. Cutaneous Manifestations of COVID-19: An Evidence-Based Review. American journal of clinical dermatology. 2020; 21:(5):62739.
    [Google Scholar]
  5. Singh H, Kaur H, Singh K, Sen CK. Cutaneous Manifestations of COVID-19: A Systematic Review. Advances in wound care. 2021; 10:(2):5180.
    [Google Scholar]
  6. Tavakolpour S, Rakhshandehroo T, Wei EX, Rashidian M. Lymphopenia during the COVID-19 infection: What it shows and what can be learned. 2020. p. 312.
    [Google Scholar]
  7. Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M et al.  Hematological findings and complications of COVID-19. American journal of hematology. 2020; 95:(7):83447.
    [Google Scholar]
  8. Oh KH, Lee SH. COVID-19 and Fungal Diseases. Antibiotics (Basel). 2022; 11:(6).
    [Google Scholar]
  9. Gallardo-ZapataJ, Maldonado-Bernal C. Natural killer cell exhaustion in SARS-CoV-2 infection. Innate Immun. 2022:17534259221077750.
    [Google Scholar]
  10. Katz J, Yue S, Xue W. Herpes simplex and herpes zoster viruses in COVID-19 patients. Ir J Med Sci. 2021:15.
    [Google Scholar]
  11. Wang F, Nie J, Wang H, Zhao Q, Xiong Y, Deng L et al.  Characteristics of Peripheral Lymphocyte Subset Alteration in COVID-19 Pneumonia. The Journal of infectious diseases. 2020; 221:(11):17629.
    [Google Scholar]
  12. Dhabhar FS. Enhancing versus suppressive effects of stress on immune function: implications for immunoprotection and immunopathology. Neuroimmunomodulation. 2009; 16:(5):30017.
    [Google Scholar]
  13. Thakur M, Datusalia AK, Kumar A. Use of steroids in COVID-19 patients: A meta-analysis. European Journal of Pharmacology. 2022;914:174579.
    [Google Scholar]
  14. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6:(7):e1000097.
    [Google Scholar]
  15. Moola S, Munn Z, Tufanaru C, Aromataris E, Sears K, Sfetcu R et al.  Systematic reviews of etiology and risk. In: Aromataris E, Z M, editors. JBI Manual for Evidence Synthesis. USA2020.
    [Google Scholar]
  16. Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003; 73:(9):7126.
    [Google Scholar]
  17. Silva DL, Lima CM, Magalhães VCR, Baltazar LM, Peres NTA, Caligiorne RB et al.  Fungal and bacterial coinfections increase mortality of severely ill COVID-19 patients. Journal of Hospital Infection. 2021;113:14554.
    [Google Scholar]
  18. Llamas-Velasco M, Rodríguez-Jiménez P, Chicharro P, De Argila D, Muñoz-Hernández P, Daudén E. Reply to “Varicella-like exanthem as a specific COVID-19-associated skin manifestation: Multicenter case series of 22 patients”: To consider varicella-like exanthem associated with COVID-19, virus varicella zoster and virus herpes simplex must be ruled o. 2020. p. e253e4.
    [Google Scholar]
  19. Kawai K, Yawn BP, Wollan P, Harpaz R. Increasing Incidence of Herpes Zoster Over a 60-year Period From a Population-based Study. Clin Infect Dis. 2016; 63:(2):2216.
    [Google Scholar]
  20. Schröder C, Enders D , Schink T, Riedel O. Incidence of herpes zoster amongst adults varies by severity of immunosuppression. The Journal of infection. 2017; 75:(3):20715.
    [Google Scholar]
  21. Saati A, Al-Husayni F, Malibari AA, Bogari AA, Alharbi M. Herpes Zoster Co-Infection in an Immunocompetent Patient With COVID-19. Cureus. 2020; 12:(7):e8998e.
    [Google Scholar]
  22. Maia CMF, Marques NP, de Lucena EHG, de Rezende LF, Martelli DRB, Martelli-Júnior H. Increased number of Herpes Zoster cases in Brazil related to the COVID-19 pandemic. International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases. 2021;104:7323.
    [Google Scholar]
  23. Marra F, Parhar K, Huang B, Vadlamudi N. Risk Factors for Herpes Zoster Infection: A Meta-Analysis. Open forum infectious diseases. 2020; 7:(1):ofaa005ofaa.
    [Google Scholar]
  24. Ferreira ACADF, Romão TT, Macedo YS, Pupe C, Nascimento OJM. COVID-19 and herpes zoster co-infection presenting with trigeminal neuropathy. European Journal of Neurology. 2020; 27:(9):174850.
    [Google Scholar]
  25. Gershon AA, Gershon MD, Breuer J, Levin MJ, Oaklander AL, Griffiths PD. Advances in the understanding of the pathogenesis and epidemiology of herpes zoster. Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology. 2010; 48: Suppl 1(Suppl 1):S27.
    [Google Scholar]
  26. Kennedy JJ, Steain M, Slobedman B, Abendroth A. Infection and Functional Modulation of Human Monocytes and Macrophages by Varicella-Zoster Virus. Journal of virology. 2019; 93:(3).
    [Google Scholar]
  27. Debuc B, Smadja DM. Is COVID-19 a New Hematologic Disease? Stem cell reviews and reports. 2021; 17:(1):48.
    [Google Scholar]
  28. Goyal S, Prabhu S, Shashikiran U, Pai SB, Mohammed A. Cutaneous manifestations of COVID-19 in skin of color: a firsthand perspective of three cases in a tertiary care center in India. Postgraduate Medicine. 2021; 133:(3):3079.
    [Google Scholar]
  29. Tartari F, Spadotto A, Zengarini C, Zanoni R, Guglielmo A, Adorno A et al.  Herpes zoster in COVID-19-positive patients. International Journal of Dermatology. 2020; 59:(8):10289.
    [Google Scholar]
  30. Xiang Q, Feng Z, Diao B, Tu C, Qiao Q, Yang H et al.  SARS-CoV-2 Induces Lymphocytopenia by Promoting Inflammation and Decimates Secondary Lymphoid Organs. Front Immunol. 2021;12:661052.
    [Google Scholar]
  31. Li T, Qiu Z, Zhang L, Han Y, He W, Liu Z, et al. Significant changes of peripheral T lymphocyte subsets in patients with severe acute respiratory syndrome. J Infect Dis. 2004; 189:(4):64851.
    [Google Scholar]
  32. Ghizlane EA, Manal M, Abderrahim EK, Abdelilah E, Mohammed M, Rajae A et al.  Lymphopenia in Covid-19: A single center retrospective study of 589 cases. Ann Med Surg (Lond). 2021;69:102816.
    [Google Scholar]
  33. Zheng M, Gao Y, Wang G, Song G, Liu S, Sun D et al.  Functional exhaustion of antiviral lymphocytes in COVID-19 patients. 2020. p. 5335.
    [Google Scholar]
  34. Welliver RC. Respiratory syncytial virus and other respiratory viruses. The Pediatric infectious disease journal. 2003; 22:(2 Suppl):S6-10; discussion S-2.
    [Google Scholar]
  35. Heitzman J. Impact of COVID-19 pandemic on mental health. Psychiatria polska. 2020; 54:(2):18798.
    [Google Scholar]
  36. Pona A, Jiwani RA, Afriyie F, Labbe J, Cook PP, Mao Y. Herpes zoster as a potential complication of coronavirus disease 2019. Dermatologic Therapy. 2020; 33:(6).
    [Google Scholar]
  37. Ozamiz-Etxebarria N, Dosil-Santamaria M, Picaza-Gorrochategui M, Idoiaga-Mondragon N. Stress, anxiety, and depression levels in the initial stage of the COVID-19 outbreak in a population sample in the northern Spain. Cadernos de saude publica. 2020; 36:(4):e00054020-e.
    [Google Scholar]
  38. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet (London, England). 2020; 395:(10227):91220.
    [Google Scholar]
  39. Eisenberger NI, Inagaki TK, Mashal NM, Irwin MR. Inflammation and social experience: an inflammatory challenge induces feelings of social disconnection in addition to depressed mood. Brain, behavior, and immunity. 2010; 24:(4):55863.
    [Google Scholar]
  40. Elsaie ML, Youssef EA, Nada HA. Herpes zoster might be an indicator for latent COVID 19 infection. Dermatologic Therapy. 2020; 33:(4).
    [Google Scholar]
  41. Altaf I. Herpes zoster coinfection and the current COVID-19 pandemic. Saudi Critical Care Journal. 2020; 4:(4):130.
    [Google Scholar]
  42. Altaf I. Herpes Zoster Co-Infection with COVID-19: A Case Series. Bali J Anesthesiol. 2021; 5:(3):1957.
    [Google Scholar]
  43. Karimi A, Tabatabaei SR, Khalili M, Sadr S, Alibeik M, Omidmalayeri S et al.  COVID-19 and chickenpox as a viral co-infection in a 12-year-old patient, a case report. Arch Pediatr Infect Dis. 2020; 8:(3):14.
    [Google Scholar]
  44. Antonescu F, Butnariu I, Cojocaru FM, Anghel DN, Mihai ED, Tuţă S. Zoster cranial polyneuropathy in a COVID-19 patient. American Journal of Case Reports. 2021; 22:(1).
    [Google Scholar]
  45. Patel P, Undavia A, Choudry R, Zhang Y, Prabhu AM. COVID-19 Associated With Concomitant Varicella Zoster Viral Encephalitis. Neurology Clinical Practice. 2021; 11:(2):e219e21.
    [Google Scholar]
  46. Jiang M, Guo Y, Luo Q, Huang Z, Zhao R, Liu S et al.  T-Cell Subset Counts in Peripheral Blood Can Be Used as Discriminatory Biomarkers for Diagnosis and Severity Prediction of Coronavirus Disease 2019. The Journal of infectious diseases. 2020; 222:(2):198202.
    [Google Scholar]
  47. Solanki K, Kohm K, Bhatt PJ. Disseminated Herpes Zoster Virus in a patient with COVID-19. Consultant. 2021; 61:(12):811.
    [Google Scholar]
  48. Russell CD, Millar JE, Baillie JK. Clinical evidence does not support corticosteroid treatment for 2019-nCoV lung injury. Lancet (London, England). 2020; 395:(10223):4735.
    [Google Scholar]
  49. Rees EM, Nightingale ES, Jafari Y, Waterlow NR, Clifford S, B Pearson CA et al. COVID-19 length of hospital stay: a systematic review and data synthesis. BMC medicine. 2020; 18:(1):270.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/qmj.2022.41
Loading
/content/journals/10.5339/qmj.2022.41
Loading

Data & Media loading...

  • Article Type: Review Article
Keyword(s): CoronavirusCOVID-19Herpes zosterSARS-CoV-2Varicella zoster virusvesicular rash and virus reactivation
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error