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Meta-Analysis
. 2022 Jan;36(1):24-38.
doi: 10.1111/jdv.17672. Epub 2021 Oct 5.

Are the chilblain-like lesions observed during the COVID-19 pandemic due to severe acute respiratory syndrome coronavirus 2? Systematic review and meta-analysis

V Sánchez-García  1 , R Hernández-Quiles  1 , E de-Miguel-Balsa  2   3 , A Docampo-Simón  1 , I Belinchón-Romero  1   3 , J M Ramos-Rincón  3   4
Affiliations
Meta-Analysis

Are the chilblain-like lesions observed during the COVID-19 pandemic due to severe acute respiratory syndrome coronavirus 2? Systematic review and meta-analysis

V Sánchez-García et al. J Eur Acad Dermatol Venereol. 2022 Jan.

Abstract

The expansion of the COVID-19 pandemic has been accompanied by numerous reports of chilblain-like lesions (CLL) in different countries; however, the pathogenesis of these lesions is still unclear. This systematic review and meta-analysis aimed to assess the prevalence of COVID-19 (diagnosed using PCR and/or serology) in patients with CLL. We undertook a literature search in PubMed, Embase, and Scopus (to 15 March 2021), including studies that reported on the number of patients with CLL with positive PCR and/or serology for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or with a clinical suspicion of COVID-19. Regardless of data heterogeneity, a random-effects model was used to pool prevalence estimates. The meta-analysis included 63 original studies, involving 2919 cases of CLL. A subgroup of these patients underwent diagnostic tests for COVID-19 (PCR: n = 1154, 39.5%; serology: n = 943, 32.3%). The pooled prevalence of COVID-19 in the overall sample and in the subgroup who were tested for COVID-19 was, respectively: (i) positive PCR: 2.6% [95% confidence interval (CI) 1.9% to 3.4%] and 5.5% (95% CI, 3.7-7.7%); (ii) positive serology for SARS-CoV-2: 7.2% (95% CI, 4.7-10.2%) and 11.8% (95% CI, 7.9-16.3%); and (iii) positive PCR and/or serology, 15.2% (95% CI, 10.4-20.7%) and 7.5% (95% CI, 5.1-10.3%). Altogether, a small proportion of diagnostic tests for SARS-CoV-2, both PCR and serologies, show positive results in patients with CLL.

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Figures

Figure 1
Figure 1
PRISMA flow chart for study selection. *Consider, if feasible to do so, reporting the number of records identified from each database or register searched (rather than the total number across all databases/registers). **If automation tools were used, indicate how many records were excluded by a human and how many were excluded by automation tools.
Figure 2
Figure 2
Pooled prevalence of positive PCRs for COVID‐19 in patients with chilblains‐like lesions, December 2019 to March 2021.
Figure 3
Figure 3
Pooled prevalence of positive serological results for SARS‐CoV‐2 antibodies in patients with chilblains‐like lesions, December 2019 to March 2021
Figure 4
Figure 4
Pooled prevalence of positive SARS‐CoV‐2 diagnostic test in patients with chilblains‐like lesions, December 2019 to March 2021.
See this image and copyright information in PMC

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