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- Title
Epidemiologic Analysis of Chilblains Cohorts Before and During the COVID-19 Pandemic.
- Authors
McCleskey, Patrick E.; Zimmerman, Bree; Lieberman, Amara; Liu, Liyan; Chen, Cynthia; Gorouhi, Farzam; Jacobson, Christine C.; Lee, David S.; Sriram, Achyuth; Thornton, Amanda; Herz, Arnd M.; Mirmirani, Paradi; Herrinton, Lisa J.
- Abstract
<bold>Importance: </bold>Beginning in March 2020, case reports and case series linked the COVID-19 pandemic with an increased occurrence of chilblains, but this association has not been evaluated in an epidemiologic study.<bold>Objective: </bold>To assess whether a correlation exists between COVID-19 incidence and chilblains incidence.<bold>Design, Setting, and Participants: </bold>A retrospective cohort study was conducted within the Kaiser Permanente Northern California system from January 1, 2016, to December 31, 2020; health plan members of all ages were included.<bold>Exposure: </bold>COVID-19 incidence in 207 location-months, representing 23 geographic locations in northern California across 9 months.<bold>Main Outcome and Measures: </bold>Chilblains incidence was the main outcome. The association of chilblains incidence with COVID-19 incidence across the 207 location-months was measured using the Spearman rank correlation coefficient.<bold>Results: </bold>Of 780 patients with chilblains reported during the pandemic, 464 were female (59.5%); mean (SD) age was 36.8 (21.8) years. COVID-19 incidence was correlated with chilblains incidence at 207 location-months (Spearman coefficient 0.18; P = .01). However, only 17 of 456 (3.7%) patients with chilblains tested during the pandemic were positive for SARS-CoV-2, and only 9 of 456 (2.0%) were positive for SARS-CoV-2 within 6 weeks of the chilblains diagnosis. Test results of 1 of 97 (1.0%) patients were positive for SARS-CoV-2 IgG antibodies. Latinx patients were disproportionately affected by COVID-19 but not by chilblains.<bold>Conclusions and Relevance: </bold>This cohort study found that in northern California, the incidence of chilblains increased during the pandemic but was correlated weakly with the incidence of COVID-19 across 207 location-months. These findings may have resulted from a causal role of COVID-19, increased care-seeking by patients with chilblains during the pandemic, or changes in behavior during shelter in place.
- Publication
JAMA Dermatology, 2021, Vol 157, Issue 8, p947
- ISSN
2168-6068
- Publication type
journal article
- DOI
10.1001/jamadermatol.2021.2120