COVID Toe refers to a rash appearing on Covid patients’ feet even in the absence of other symptoms.
At first, the toes look swollen and take on a reddish tint; sometimes a part of the toe is swollen, and individual lesions or bumps can be seen. Over time, the lesions become purple in color.
Five rashes, including Covid toe, are affecting some hospital patients diagnosed with Covid-19, a small study by Spanish doctors has found. The rashes tended to appear in younger people and last for several days.
The researchers said they were surprised to see so many varieties of rash with Covid-19 which are not currently included in the list of symptoms of the illness.
There have been many reports about “Covid toe”, but lead researcher Dr Ignacio Garcia-Doval said the most common form of rash in the study was maculopapules – small, flat and raised red bumps that tend to appear on the torso.
Dr Ignacio Garcia-Doval says, “It usually appears later on, after the respiratory manifestation of the disease.
The toe cases make up half of all reports filed by skin doctors around the world to a new international registry started by the American Academy of Dermatology, which is tracking the complications.
No one knows exactly why the new coronavirus might cause chilblain-like lesions. One hypothesis is that they are caused by inflammation, a prominent feature of Covid-19. Inflammation also causes one of the most serious syndromes associated with the coronavirus, acute respiratory distress syndrome.
Other hypotheses are that the lesions are caused by inflammation in the walls of blood vessels, or by small micro clots in the blood. (Clotting has been another feature of the disease.)
The lesions seen in otherwise healthy people appear to be distinct from those that doctors are seeing in some critically ill Covid-19 patients in intensive care, who are prone to developing blood clots.
Some of these clots may be very small and can block the tiny vessels in the extremities, causing rashes on the toes, said Dr. Humberto Choi, a pulmonologist and critical care physician at the Cleveland Clinic.
Some experts now believe Covid toe should be recognized as sufficient grounds for testing, even in the absence of other symptoms.
COVID toes recommendation
Patients who develop swollen toes and red and purple lesions are advised to consult their primary care doctor or a dermatologist to rule out other possible causes. But, experts said, they should not run to the emergency room, where they risk being exposed to the coronavirus or exposing others if they are infected.
“The good news is that the chilblain-like lesions usually mean you’re going to be fine,” Dr. Fox said. “Usually it’s a good sign your body has seen Covid and is making a good immune reaction to it.”