There are a lot of unknowns about COVID-19, sparking all sorts of controversial speculation about symptoms, treatments, and containment strategies from all kinds of sources that vary widely in credibility. One of the new findings that are currently drawing attention is the presence of purple lesions on the toes of some COVID patients.
Common COVID Symptoms
The main symptoms of COVID-19 are respiratory ones such as coughing, fever, and difficulty breathing. General symptoms such as exhaustion, aches, and pains are also common. These symptoms generally appear within 14 days of exposure to the novel coronavirus.1 Other less common symptoms include:
- Nasal congestion
- Diarrhea
- Loss of taste
- Chills
- Headaches
One of the complicating factors about COVID-19 is that the disease manifests in different ways from individual to individual. Up to 80% of patients will have mild symptoms, and some may show no symptoms.2 When the disease affects the lungs, it can precipitate a host of troubling symptoms, triggering pneumonia, or an immune overreaction, pushing it to the more severe and dangerous manifestations of the disease.
Cutaneous Manifestations
One of the symptoms that are being looked at in recent weeks is a frostbite-like mark on patients with COVID-19. These lesions appear on the toes, and they are the first dermatological manifestations to be scrutinized. They can also manifest in the fingers. In a report from Italy, dermatological manifestations have been studied, and it suggests that up to 20% of patients showed signs of skin involvement.3 The sample is limited naturally, with only 88 patients being studied, and there may be other variables as well. Blood clotting, which is one of the speculated symptoms of COVID infection, maybe manifesting as frostbite-like symptoms on the digits. Dubbed COVID toes, it is likely to be one of the early symptoms of COVID-19, before more severe symptoms appear. From the reporting, some of the signs of COVID toes include:
- Red or purple welts that look like frostbite on the toes or fingers
- Burning sensation
- Pain
The cause of this is unclear, although several theories have been proposed. Cutaneous manifestations aren’t rare with viral infections. These may be occurring due to general inflammation caused by the body’s immune system, or it may be due to another factor like clotting of blood.
Children and COVID
Age is one of the most important factors in how dangerous COVID-19 is. Children rarely have the severe symptoms seen in adults, and in the elderly and the risk increases proportionate to the patient’s age. As scary as this virus has been, it hasn’t hit children very hard from a statistical view. The symptoms have also been largely mild in children. Looking at it from the other side, children can become potential vectors of spread if their symptoms are either mild or non-existent, but we’re still capable of spreading the virus. There is, however, a lot of uncertainty and lack of information in this area as this crisis is still very new.
The frostbite-like sores may act as a marker for early disease in patients who may not have other symptoms or patients who may become sick later. Some areas are recording this symptom in their registry. The database may help in the future to identify signs that a patient may have an infection before other more clear symptoms show up, or to detect infection in asymptomatic patients.
1https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/symptoms.html
2https://www.ncbi.nlm.nih.gov/pubmed/32064853
3https://www.ncbi.nlm.nih.gov/pubmed/32215952
4https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-daily-data-summary-deaths-04152020-1.pdf
