Posted on: May 1, 2020 at 10:05 pm

Since the COVID-19 pandemic began, the main symptoms that have been reported are fever, dry cough, tiredness, and shortness of breath. As the virus has progressed, more symptoms have become known, such as gastrointestinal distress and diarrhea [1].

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Even after more than three million people have been infected worldwide, there is still much we don’t know about the novel coronavirus, and everyday scientists and medical experts are observing new changes and learning more about how it spreads and how it acts in the human body.

Recently, doctors around the country have begun describing a strange new symptom that they are seeing in some of their patients, and they are suspecting that it is related to COVID-19.

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COVID Toes

This mysterious skin condition that is appearing around the country causes the toes, and occasionally the fingers, to turn purple, blue, or red in color. Some doctors, such as Dr. Amy Paller at Northwestern University, have reported seeing up to thirty cases of this strange occurrence [2].

The condition is similar in appearance to frostbite and could appear on the underside of the foot, the top of the foot, or the toes. Occasionally, the skin may be cracked or dry-looking as well [3].

Read: Boy With Cystic Fibrosis Has Big Smile After Beating Coronavirus

Is it Really a Symptom of the Coronavirus?

So far, it seems that patients who have “COVID toes” do not exhibit any other symptoms of the virus, however, doctors believe that it is still connected to COVID-19.

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“…it seems too much of a coincidence not to be a manifestation of the virus,” says Paller [2].

The majority of COVID toes cases have been reported in children, teens, and young adults in their twenties.

“COVID toes is a skin finding that we are seeing in some children, but also some adults that are diagnosed with COVID. Even people that haven’t been diagnosed, we’re seeing it more and more,” said Pediatric emergency physician Dr. Dina Kulik [3].

Dr. Ebbing Lautenbach, chief of infectious disease at the University of Pennsylvania’s School of Medicine, explained that this symptom typically occurs early on in the disease, so if you do notice it, you should get tested, since the symptoms could still progress [2].

Dr. Paller says that there have been a small number of patients with the condition who have actually tested negative for the virus, however, they still believe that the two are connected.

“Many have had some mild viral symptoms in the week before and it might be a sign during the ‘convalescent’ healing period when no longer contagious,” she says [2].

One of Cleavland Clinic’s Pulmonologist Humberto Choi, MD, explains that while these symptoms are more attention-grabbing than others, they still are not widespread.

“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.” [4]

Related: Health Authorities Issue Alert About a Rare Coronavirus-Related Condition in Children

Why is this Just Happening Now?

Dr. Choi explains that it is actually quite common for people to develop rashes when they’re fighting an infection, particularly a viral and respiratory one such as this. New symptoms like this continue to appear because people tend to react to infections in different ways. The more people who continue to become infected with the virus, the greater variety of symptoms we will begin to see.

“It’s not uncommon for someone to have a viral infection and have a rash or blotchy areas on their body. This can happen with other viral respiratory infections like measles. And sometimes, antibiotics might cause skin rashes,” says Dr. Choi [4].

So far, however, there is no specific rash pattern that has been associated with the COVID-19 virus. As for why COVID toes are happening, doctors still are not quite sure.

According to Lautenbach, there are two possible causes. One is that it could simply be an inflammatory response to the virus that is localized to the feet and toes, or another could be that it is caused by the clotting of blood vessels [2].

Dr. Marla Shapiro explains that COVID-19 can cause a heightened immune response, even in children who have not exhibited other symptoms. This could cause what is called vasculitis, which is inflammation of the small blood vessels that are typically at the ends of toes and fingers.

“[It’s] almost as if you have these little, mini clots in them due to the inflammation and that’s giving you the purple-bluish lesions,” she said [3].

She explained that while some patients seem to be developing fast-moving and potentially life-threatening blood clots as a result of the virus, the ones they are seeing in toes and fingers are most likely too small to become a serious issue as they are in other parts of the body [3].

What are Doctors Doing About COVID Toes?

There is no treatment for the skin lesions, but the positive is that they typically disappear within one week to ten days [2].

Kulik says that for this reason, when doctors are presented with a patient who has COVID toes, they usually just watch and wait.

“Certainly if the person is feeling discomfort to take a pain medicine could be helpful or using topical medicine like hydrocortisone to decrease the inflammation or the itch if they’re bothering the person,” she said [3].

Kulik says that If you or your child is unwell, you should seek medical care, and if it is an emergency you should certainly go to the emergency room. If, however, their only symptom is a rash, it is best to contact your physician virtually and keep them isolated so that they don’t come into contact with anyone who is more vulnerable or at risk for a serious infection [3].

As always, if you are ever uncertain, you should contact your local health unit right away, and they will be able to direct you as to what steps you should take.

Keep Reading: Video: How Coronavirus Attacks the Body

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Brittany Hambleton
Team Writer
Brittany is a freelance writer and editor with a Bachelor of Science in Foods and Nutrition and a writer’s certificate from the University of Western Ontario. She enjoyed a stint as a personal trainer and is an avid runner. Brittany loves to combine running and traveling, and has run numerous races across North America and Europe. She also loves chocolate more than anything else… the darker, the better!

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