Telogen Effluvium and COVID-19: a case and a brief review of literature

Authors

DOI:

https://doi.org/10.11606/issn.2176-7262.rmrp.2022.180629

Keywords:

Alopecia, Coronavirus infections , Fever, Immune system, Cytokines

Abstract

COVID-19 is a new disease that has brought a great impact on global morbidity and mortality. There have been increasingly frequent reports of persistent symptoms and/or clinical manifestations attributed to COVID-19 after the acute phase of the disease. In this article, we present a case of post-COVID-19 telogen effluvium in a 39-year-old hypertensive and obese patient who looked for medical attention due to massive hair loss. Previous history of moderate COVID-19 4 months ago. After investigation and exclusion of other possible causes of telogen effluvium well established in the literature, the condition was attributed to the previous episode
of COVID-19. Persistent fever, the cytokine storm, and the entire immunological cascade of COVID-19 can
lead to apoptosis of the keratinocytes of the hair follicles, initiating the catagen phase early followed by the telogen phase with a consequent capillary release. Late symptoms possibly secondary to COVID-19 should receive attention and interest from the medical and scientific community. As it is a new disease, whose late consequences are not yet fully known/elucidated, careful observation and careful clinical follow-up of these patients are recommended.

Downloads

Download data is not yet available.

Author Biographies

  • Francisco Kleyton Zacarias Florêncio, Universidade Federal de Pernambuco. Hospital das Clínicas, Recife, (PE), Brasil

    Médico graduado

  • Maiza de Oliveira Tenório, Universidade Federal de Pernambuco. Centro de Ciências Médicas, Recife, (PE), Brasil

    Estudante de medicina

  • Sandro Gonçalves de Lima, Universidade Federal de Pernambuco. Departamento de Medicina Clínica, Recife, (PE), Brasil

    PhD, cardiologista, professor de cardiologia

References

Baj J, Karakula-Juchnowicz H, Teresiński G, Buszewicz G, Ciesielka M, Sitartz E et al. COVID-19: Specific and Non-Specific Clinical Manifestations and Symptoms: The Current State of Knowledge. J. Clin. Med. 2020;9(6):1753. DOI: https://doi.org/10.3390/jcm9061753

John Hopkins University [homepage on internet]. COVID-19 Map [accessed on 03 mar 2022]. Available in: https://coronavirus.jhu.edu/map.html

Ministério da Saúde [homepage on internet]. Painel Coronavírus [acessed on 03 mar 2022]. Available in : https://covid.saude.gov.br/

Xiong Q, Xu M, Li J, Yinghui L, Zhang J, Xu Y, et al. Clinical sequelae of COVID-19 survivors in Wuhan, China: a single-centre longitudinal study. Clin Microbiol Infect. 2020;27(1):89-95. DOI: https://doi.org/10.1016/j.cmi.2020.09.023

Torres LA, Garrido EC, Borja PM. Trombo en la aurícula derecha tras neumonía por COVID-19. Rev Esp Cardiol. 2020;73(10):845. DOI: https://doi.org/10.1016/j.recesp.2020.06.007

Tung-Chen Y, Blanco-Alonso S, Antón-Huguet B, Figueras-López C, Ugueto-Rodrigo C. Dolor torácico persistente tras resolución de la enfermedad por coronavirus 2019 (COVID-19). Semergen. 2020;46(S1):88-90. DOI: https://doi.org/10.1016/j.semerg.2020.06.006

Azizi SA, Azizi S. Neurological injuries in COVID-19 patients: direct viral invasion or a bystander injury after infection of epithelial/endothelial cells. J Neurovirol. 2020;26:631-41. DOI: https://doi.org/10.1007/s13365-020-00903-7

Revés J, Brochado AI, Costa CA, Araújo IM. Exantema Maculopapular como Manifestação Tardia da Infeção por SARS-CoV-2. Medicina Interna. 2020;27(4):324-5. DOI: https://doi.org/10.24950/Imagem/150/20/4/2020

Seque CA, Simões MM, Enokihara S, Porro AM, Tomimori J. Manifestações Cutâneas Associadas à COVID-19. Anais Brasileiros de Dermatologia. 2022;97(1):75-88.

Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F, et al. Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. N Engl J Med [Internet]. 2020;383(2):120–8. DOI: https://doi.org/10.1056/NEJMoa2015432

Varga Z, Flammer AJ, Steiger P, Haberecker M, Andermatt R, Zinkernagel AS, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet [Internet]. 2020;395(10234):1417–8. DOI: https://doi.org/10.1016/ S01406736(20)30937-5

Bourgonje AR, Abdulle AE, Timens W, Hillebrands JL, Navis GJ, Gordijn SJ, et al. Angiotensin-converting enzyme 2 (ACE2), SARS-CoV-2 and the pathophysiology of coronavirus disease 2019 (COVID-19). J Pathol. 2020;251(3):228-48. DOI: https://doi.org/10.1002/path.5471

Hu B, Huang S, Yin L. The cytokine storm and COVID-19. J Med Virol. 2020;1-7. DOI: https://doi.org/10.1002/jmv.26232

Asghar F, Shamim N, Farooque U, Sheikh H, Aqeel R. Telogen Effluvium: A Review of the Literature. Cureus. 2020;12(5):e8320. DOI: https://doi.org/10.7759/cureus.8320

Malkud S. Telogen Effluvium: A Review. J Clin Diagn Res. 2015;9(9):WE01-3. DOI: https://doi.org/10.7860/JCDR/2015/15219.6492

Mitrani RD, Dabas N, Goldberger JJ. COVID-19 cardiac injury: Implications for long-term surveillance and outcomes in survivors. Heart Rhythm. 2020;17(11):1984-90. DOI: https://doi.org/10.1016/j.hrthm.2020.06.026

Lang M, Buch K, Li MD, Mehan WA, Lang AL, Leslie-Mazwi TM, et al. Leukoencephalopathy associated with severe COVID-19 infection: sequela of hypoxemia?. Am J Neuroradiol. 2020;41(9):1641-5. DOI: https://doi.org/10.3174/ajnr.A6671

Recalcati S. Cutaneous manifestations in COVID-19: a first perspective. J. Eur. Acad. Dermatol. Venereol. 2020, 34(5):e212-13. DOI: https://doi.org/10.1111/jdv.16387

Soto SMA, Mestre MPD. Efluvio telógeno: una manifestación del síndrome Post-COVID-19. Piel. 2021:1-3. DOI: https://doi.org/10.1016/j.piel.2021.06.013

Kutulu Ö, Aktas H, İmren I, Metin H. Short-term stress-related increasing cases of alopecia areata during the COVID-19 pandemic. Journal of Dermatological Treatment. 2020; 1. DOI: https://doi.org/10.1080/09546634.2020.1782820 [published online ahead of print, 2020 Jun 19].

Downloads

Published

2022-11-09

Issue

Section

Relato de Caso

How to Cite

1.
Florêncio FKZ, Tenório M de O, Lima SG de. Telogen Effluvium and COVID-19: a case and a brief review of literature. Medicina (Ribeirão Preto) [Internet]. 2022 Nov. 9 [cited 2024 Jun. 1];55(3):e-180629. Available from: https://www.periodicos.usp.br/rmrp/article/view/180629