Many of them had symptoms similar to COVID-19 several weeks before their toe lesions appeared. “COVID toes” appeared as red or purple lesions that were tender, itchy or both.
“Patients with ‘COVID toes’ seem to be healthy when it presents and we wonder if they could be in the process of mounting an antibody response to the virus with secondary inflammation,” Gehris told the Pittsburgh Post-Gazette.
While COVID toes and rashes have been associated with the coronavirus more than other viral infections, Pulmonologist Dr. Humberto Choi explains that these symptoms haven’t been widespread so far.
“These symptoms seem to be more common in COVID-19 compared with all other viral infections,” says Dr. Choi. “But at this time, they haven’t affected a majority of people. So, the symptoms that people should be looking for are really a fever, cough and muscle aches that you can get when you have a viral infection.
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Those are the most common symptoms — and those are the things that people should be keeping on their radar.”
Dermatology experts say one of the challenges around these lesions is that the knowledge is continuing to evolve around how they counsel patients regarding quarantine at this time. People should be following CDC and local guidelines in terms of self-isolating, regardless. We know that some patients who develop the pernio-like lesions of their feet are still infectious, because they are testing PCR positive for the virus.
This means that there is a potential risk of transmitting the virus to others. It seems that some people may develop these lesions while they are still infectious, while others may develop them somewhat later in the disease course. We need more data on the timing of these pernio-like lesions so we can better guide our providers on how to counsel their patients. That is an area we are actively working on.
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This has public health implications because if your patient is potentially still infectious when their toes are purple, that is a different story than if they are not infectious and they are already basically over the infectious stage of the virus.
