Covid: Rash is ONLY symptom for 21% of patients, KCL study says

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From a high fever to a dry cough, coronavirus has been known to be associated with a range of unpleasant symptoms.

Now, new data shows that for one in five people who get Covid-19, their only symptom is a rash.

In an additional 17 percent of cases, a rash is the first symptom before others develop later.

The rash manifests itself in a variety of ways, including as hives or bumps. They are registered all over the body.

The data comes from the ZOE symptom tracker app from researchers at King’s College London (KCL), which kept Covid operational during the pandemic.

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For one in five people who get Covid-19, the only symptom is a rash, new data shows. Pictured, a case of 'Covid numbers'

For one in five people who get Covid-19, the only symptom is a rash, new data shows. Pictured, a case of ‘Covid numbers’

More than 400 people submitted images, which are now published in an online database called Covid skin signs. The range of the rashes is astonishing, manifesting in hives (see photo) or raised bumps and visible all over the body

More than 400 people submitted images, which are now published in an online database called Covid skin signs. The range of the rashes is astonishing, manifesting in hives (see photo) or raised bumps and visible all over the body

ZOE data found that people who tested positive for Covid were 67 percent more likely to have a rash than someone who was not infected.

Another independent survey was conducted among 11,544 people who were asked to provide photos of their rashes as well.

“Interestingly, among the respondents to the independent online survey, we found that one percent of SARS-CoV-2 positive cases reported a rash as the first presentation and 21 percent as the only clinical sign of COVID-19,” the researchers write.

The study was published in the British Journal of Dermatology, and more than 400 people submitted images, which are now published in an online database called Covid skin signs.

The images are categorized according to the type of rash they are and include “Covid grades”, “Purpuric”, “Oral” and “Uticarial”.

The rash manifests itself in a variety of ways, including as hives or bumps. They are registered all over the body.

“Rashes cluster with other COVID-19 symptoms, are predictive of a positive swab test, and occur in a significant number of cases, alone or before other classic symptoms,” the researchers write.

The Different Types of Covid-Related Rashes

  • COVID numbers – A rash that affects the limbs, namely fingers and toes. The skin changes are known as chilblains. This rash appears to be more common in younger people. The rash appears as reddish and purplish bumps on the fingers or toes and can appear on many digits.
  • Neck & exposed breast eczema – A rash that appears on the neck or chest in areas exposed to sunlight. It is usually quite pink and very itchy. It can occur at any time during or after the infection and usually lasts a long time.
  • Oral – A rash affecting the lips can make them feel painful and become dry and flaky during recovery. Pain in the mouth can also occur.
  • Papular and vesicular – It appears as red and bumpy areas that can appear anywhere on the body. It can look like bad prickly heat. In some cases it is just small bumps all over the skin and it is usually very itchy. The rash can also last a long time after the person has recovered from the infection
  • Pityriasis Rosea – An acute rash recognized by dermatologists. It is believed to be viral in origin, although it has never been proven. It usually affects young individuals. There are more reports of this pattern during the pandemic, presenting first with a first large ‘herald’ patch, followed a few days later by multiple smaller spots on the trunk or proximal limbs. It may take several months for it to be cleaned up.
  • Purpuric – Easily recognizable as it has multiple deep red or purplish spots. It can cause bruising. The spots or patches are caused by damage to the superficial small blood vessels with bleeding in the skin.
  • Urticarial Present quite early in the infection, but can also last a long time if the affected person is no longer contagious. The rash appears as sudden bumps or bumps on the skin that come and go quite quickly after hours and usually itchy. It can affect any part of the body. If it affects the face, it can cause swelling of the lips and eyelids. It is usually treated with antihistamines.
  • Viral exanthem – A common pattern in viral infections with a symmetrical rash with numerous reddish spots or bumps all over the body. It is usually accompanied by symptoms of a viral illness such as fever, cough and malaise. Patients suspected of having COVID may show this pattern but may not have other symptoms.
Pictured, a pupuric rash seen on the lower leg of a Covid patient. A pupuric rash looks like a lot of small blood spots on the skin and is caused by leaky blood vessels

Pictured, a pupuric rash seen on the lower leg of a Covid patient. A pupuric rash looks like a lot of small blood spots on the skin and is caused by leaky blood vessels

This person's rash was categorized as pityrias rosea, a type of rash that starts as a single red and scaly area that spreads across the trunk and upper limbs

This person’s rash was categorized as pityrias rosea, a type of rash that starts as a single red and scaly area that spreads across the trunk and upper limbs

Oral rashes were also reported by some of the more than 400 people who sent images of their Covid-related rashes to Covidskinsigns.com.

Oral rashes were also reported by some of the more than 400 people who sent images of their Covid-related rashes to Covidskinsigns.com.

Almost half of Covid patients experience swollen salivary glands

From a high fever to a loss of sense of smell, Covid-19 has been associated with a range of unpleasant symptoms.

Now, a new study has warned that infection with the coronavirus can also lead to swollen salivary glands in the mouth.

Researchers studied 122 Covid-19 patients in Italy who contracted the virus and were hospitalized between July 23 and September 7, 2020.

At three-month follow-up appointments, it was found that more than eight out of ten patients had some form of facial or mouth problem as a result of the infection.

The most common was swollen salivary glands, known as ectasia, which affected 43 percent of patients. Salivary glands make spit to aid in chewing and swallowing.

“Recognizing a rash is important in identifying new and previous cases of Covid-19.”

The coronavirus attacks different body systems, which is why there are numerous symptoms of Covid-19.

But only the ‘classic triad’ symptoms of a dry cough, fever, and loss of smell or taste are currently recognized by the NHS.

Loss of smell and taste was officially recognized as a symptom of Covid on May 18, 2020.

In June, KCL academics called for a rash to be considered the fourth official symptom of Covid.

Researchers at KCL recently again called on policymakers to expand the range of recognized symptoms.

They said expanding the list of symptoms to include fatigue, sore throats, headaches and diarrhea would allow detecting “millions” of unconfirmed cases.

Under current testing and tracking rules, swabs are only reserved for people with a fever, persistent cough or loss of smell or taste.

Professor Tim Spector, chief scientist on the Zoe app, an epidemiologist at King’s College London and a co-author of the latest rash-related study, said in February: cough, fever and anosmia miss a significant proportion of the positive cases.

“We identified anosmia as a symptom in May, and our work led the government to add it to the list; it is now clear that we need to add more.

“By inviting users who register new symptoms for a test, we have confirmed that there are many more symptoms of Covid.”

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