Covid: Skin rashes are ONLY symptom for 21% patients, says KCL study


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

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

In a further 17 per cent of cases a rash is the first symptom before others develop later.

The rashes manifest in various ways, including as hives or raised lumps. They have been recorded across the entire body. 

The data comes from the ZOE symptom tracker app run by King’s College London (KCL) researchers which has been operational Covid throughout the pandemic.

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For one in five people who catch Covid-19 they’re only symptom is a skin rash, new data shows. Pictured, a case of ‘Covid digits’ 

More than 400 people submitted images, which have now been published in an online database called Covid skin signs. The range of the rashes is astonishing, manifesting in hives (pictured) or raised lumps and seen across the entire body

More than 400 people submitted images, which have now been published in an online database called Covid skin signs. The range of the rashes is astonishing, manifesting in hives (pictured) or raised lumps and seen across the entire body

ZOE data found people who tested positive for Covid were 67 per cent more likely to develop a rash than someone who was uninfected.  

A further independent study was done on 11,544 people who were asked to also provide pictures of their rashes. 

‘Strikingly, among the respondents of the independent online survey, we found that one per cent of SARS‐CoV‐2‐positive cases reported skin rashes as the first presentation, and 21 per cent 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 have now been published in an online database called Covid skin signs. 

The images are categorised based on the sort of rash they are, and include ‘Covid digits’, ‘purpuric’, ‘oral’ and ‘uticarial’.

The rashes manifest in various ways, including as hives or raised lumps. They have been recorded across the entire body . 

‘Skin rashes cluster with other COVID‐19 symptoms, are predictive of a positive swab test, and occur in a significant number of cases, either alone or before other classical symptoms,’ the researchers write. 

‘Recognizing rashes is important in identifying new and earlier cases of Covid‐19.’

Dr Emma Wedgeworth, Consultant Dermatologist and British Skin Foundation spokesperson, told MailOnline: ‘We have become increasingly aware that skin rashes can be a sign of Covid-19 and indeed in some patients, the only sign. Rashes associated with covid can vary significantly. 

‘Hives, small blisters and red spots & bumps have all been described on the body. 

‘Chilblain-like lesions and changes in the blood supply to the hands and feet can also be a sign. 

‘Doctors and the general public should be alert to the fact that unusual changes in the skin may be a manifestation of Covid-19.’

The different types of Covid-related rashes 

  • COVID Digits – A rash that affects the extremities, namely fingers and toes. The skin changes are known as chilblains. This rash seems to be more common in younger people. The rash appears as reddish and purplish bumps on the fingers or toes and can affect many digits.
  • Neck & Exposed Chest Eczema – A rash which appears on the neck or chest at sites exposed to sunlight. It is usually quite pink and is very itchy. It can appear at any time during or after the infection and usually lasts a long time.
  • Oral – A rash which affects the lips can make them feel sore and can become dry and scaly as they recover. Soreness inside the mouth can also occur.
  • Papular & Vesicular – It appears as red and bumpy areas which may occur anywhere on the body. It can resemble bad prickly heat. In some cases, it is only tiny bumps all over the skin and is usually very itchy. The rash can also last well after the person has recovered from the infection 
  • Pityriasis Rosea – An acute eruption recognised by Dermatologists. It is thought to be viral in origin, although never proven. It usually affects young individuals. More reports of this pattern during the pandemic have been reported which first present with an initial large “herald” patch, followed a few days later by multiple smaller patches on the torso or proximal limbs. It can last several months before clearing.
  • Purpuric – Easily recognisable as it presents with multiple deep red or purplish spots. It can cause bruise-like patches. The spots or patches are caused by damage in the superficial tiny blood vessels with bleeding into the skin.
  • Urticarial – Present quite early in the infection but can also last a long time later when the affected person is no longer contagious. The rash appears as sudden raised hives or wheals on the skin which come and go quite quickly over hours and are usually intensely itchy. It can involve 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 comprising numerous reddish blotches or bumps over the body. It is usually accompanied by symptoms of a viral illness, such as fever, cough and malaise. Patients with suspected COVID could present with this pattern, but may have no other symptoms.
Pictured, a pupuric rash which was seen on a Covid patient's lower leg. A pupuric rash looks like lots of small spots of blood on the skin and is caused by blood vessels leaking

Pictured, a pupuric rash which was seen on a Covid patient’s lower leg. A pupuric rash looks like lots of small spots of blood on the skin and is caused by blood vessels leaking 

This individual's rash was categorised as pityrias rosea, a type of rash that starts as a single red and scaly area which spreads across the torso and upper limbs

This individual’s rash was categorised as pityrias rosea, a type of rash that starts as a single red and scaly area which spreads across the torso and upper limbs 

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

Oral rashes were also reported by some of the more than 400 people who submitted 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 is 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 caught the virus and were admitted hospital between July 23 and September 7, 2020. 

Follow-up appointments over three months found more than eight out of ten patients had some form of facial or mouth issue as a result of the infection. 

The most common was swollen salivary glands, known as ectasia, which affected 43 per cent of patients. Salivary glands make spit to help with chewing and swallowing.

The coronavirus attacks several bodily systems and therefore there are a host of symptoms of Covid-19.

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

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

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

Researchers from KCL recently again called for policymakers to extend the set of recognised symptoms 

They said extending the list of symptoms to include fatigue, sore throat, headache and diarrhoea would allow ‘millions’ of unconfirmed cases to be detected.   

Current Test and Trace rules mean swabs are only reserved for people with a fever, continuous cough or loss of smell or taste.    

Professor Tim Spector, lead scientist on the Zoe app, an epidemiologist at King’s College London and a co-author on the latest rash-related study, said in February: ‘We’ve known since the beginning that just focusing testing on the classic triad of cough, fever and anosmia misses a significant proportion of positive cases.   

‘We identified anosmia as a symptom back in May and our work led to the Government adding it to the list; it is now clear that we need to add more.

‘By inviting any users who log any new symptoms to get a test, we confirmed that there are many more symptoms of Covid.’



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