Publication:

Cutaneous hyperalgesia in the setting of COVID-19 infection: reporting 2 cases from North India

COVID-19 (Coronavirus disease) infection can manifest with a variety of dermatological and neurological symptoms which might have similar underlying patho-mechanisms. Here we report 2 cases of rt-PCR (Real time PCR) positive COVID infection who developed cutaneous hyperalgesia during the illness and review the case reports, case series, and other literature available on this symptom. We found that out of the total 13 reported cases (including the two cases reported here), most common onset of this symptom was within the first 3 days of illness (median duration ten days). Common sites of involvement included abdomen and back, but chest, arms and legs could also be involved. Warm baths, gabapentin and pregabalin showed good efficacy in relieving the symptom. The exact pathogenesis remains unclear but is hypothesised to be due to the neurotrophic properties of the virus and/or the inflammatory cytokines released during the illness. Further studies are necessary to expand the scope of knowledge in this regard.