Covid toe, caused by the immune response to the virus, not the virus itself
To study skin and blood endothelial and immune system activation
In chilblain-like lesions (CLL),
CLL in comparison with healthy controls and seasonal chilblains (SC)
(cold-induced sporadic chilblains occurring during 2015 and 2019)
Saint-Louis Hospital, Paris, France
N = 50
Assessment of interferon-stimulated gene expression in whole blood
Soluble markers of endothelial activation and/or angiogenesis
Lateral flow spike assay
Circulating endothelial cell counting
Histological patterns were similar in CLL and SC groups
Transcriptomic signatures overlapped in both the CLL and SC groups
Type I interferon
Cytotoxic–natural killer gene signature
CLL were characterized by higher IgA tissue deposition
More complement and angiogenesis factors in CLL compared with SC
Confirmed endothelial dysfunction in CLL
Microangiopathy leading to clinical chilblains
Disrupt the thrombo-protective state of endothelial cells
Likely contributing to microvascular thrombosis
Systemic endothelial activation?
The PT ratio and aPTT were normal in all patients
Only three patients (6%) had a moderate increase in D-dimer levels
Inflammation in the skin in CLL
Associated with endothelial alteration
Immune infiltration of cytotoxic and type I IFN-leading to clinical manifestations
UK podiatrist Dr Ivan Bristow
like the regular chilblains typically seen during cold spells and in people who have problems with circulation – the lesions usually go away on their own.
But some may need treatment with creams and other drugs.
The confirmation of the cause will help to develop new treatments to manage it more effectively
Dr Veronique Bataille, consultant dermatologist, British Skin Foundation
Covid toe was seen very frequently during the early phase of the pandemic, but has been less common in the current Delta variant wave.
That might be down to more people being vaccinated or having some protection against Covid from past infections.
Presentations after vaccination are much rarer
Delayed presentation my mean link is missed
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