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Clinical Report

Long-term Outcome of Chilblains Associated with SARS-CoV-2

Florence Poizeau, Sébastien Barbarot, Yannick Le Corre, Emilie Brenaut, Mahtab Samimi, Hélène Aubert, Alexis Toubel, Alain Dupuy
DOI: 10.2340/00015555-3930

Abstract

Numerous cases of chilblains have been observed associated with the COVID-19 pandemic. The aims of this study were to provide comprehensive follow-up data for patients reporting chilblains, and to determine the risk factors for incomplete recovery. Patients referred to 5 hospitals in France between March and May 2020 for chilblains were surveyed on December 2020. A teleconsultation was offered. Among 82 patients reporting chilblains, 27 (33%) reported complete recovery, 33 (40%) had recurrences of chilblains after their hands and feet had returned to normal, and 22 (27%) developed persistent acral manifestations, mostly acrocyanosis, with or without further recurrences of chilblains. Most recurrences of chilblains occurred during the following autumn and winter. A past history of chilblains was not associated with recurrences or persistent acral manifestations. Women had a significantly higher risk of developing recurrences or persistent acral manifestations (odds ratio (OR) 1.30; 95% confidence interval (95% CI) 1.06–1.59). In conclusion, two-thirds of patients reporting chilblains at the start of the COVID-19 pandemic experienced persistent or recurrent acral manifestations after a 10-month follow-up.

Significance

Reports on the long-term outcome of patients with chilblains associated with SARS-CoV-2 are rare and fragmentary. This study provides comprehensive follow-up data for 82 patients who reported chilblains during spring 2020 at the beginning of the COVID-19 pandemic in France. Two-thirds of patients reported recurrences of chilblains or persistence of acral manifestations over a 10–12-month follow-up. Recurrences of chilblains mostly occurred during autumn and winter 2020, suggesting that either weather conditions or further contact with SARS-CoV-2 could act as new triggers. Women had a higher risk of experiencing incomplete recovery.

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