A Cross-Sectional Study on Herpes Zoster Diagnosis in the time of COVID-19

Main Article Content

Keywords

COVID-19, herpes zoster, cross-sectional study, pandemic, coronavirus, shingles

Abstract

Background: COVID-19 infections have presented with various cutaneous manifestations in COVID-19 positive patients, including reports of rising cases of herpes zoster (HZ).  


Objective: Our investigation sought to investigate the proposed association between a positive COVID-19 test result and herpes zoster infection as well as determine whether the COVID-19 pandemic has affected the overall incidence of HZ.


Methods: In this cross- sectional study, de-identified patient data was collected from the University of California COVID Research Data Set (UC CORDS), a centralized, rapidly accumulating database of COVID-19 tested patients. Patients were divided into those diagnosed with HZ before COVID test and those with HZ after COVID testing. The University of California Health Data Warehouse was then used to collect the total number of HZ cases from March to August in 2019 and 2020 to calculate and compare the HZ condition rate.


Results: A total of 608 patients were diagnosed with HZ from March 1 to August 31, 2020; of which, 2.1% (n=13) tested positive for COVID-19. From March to August 2019 there were 4,349 reported HZ cases, and in comparison, there were 3,551 reported cases of HZ in 2020, a significant decrease (χ2 =90.6454, p<.00001).


Conclusion: In this limited dataset, there was no evidence to substantiate an association between HZ and COVID-19 infection, nor was there an increase in the number of cases of HZ during the time of the COVID-19 pandemic.

References

1. Tartari F, Spadotto A, Zengarini C, et al. Herpes zoster in COVID-19-positive patients. Int J Dermatol. 2020;59(8):1028-1029. doi:10.1111/ijd.15001

2. Shors AR. Herpes zoster and severe acute herpetic neuralgia as a complication of COVID-19 infection. JAAD Case Rep. 2020;6(7):656-657. doi:10.1016/j.jdcr.2020.05.012

3. Ertugrul G, Aktas H. Herpes zoster cases increased during COVID-19 outbreak. Is it possible a relation? [published online ahead of print, 2020 Jul 7]. J Dermatolog Treat. 2020;1. doi:10.1080/09546634.2020.1789040

4. de Freitas Ferreira ACA, Romão TT, SIlva Macedo Y, Pupe C, Nascimento OJ. COVID-19 and herpes zoster co-infection presenting with trigeminal neuropathy [published online ahead of print, 2020 May 24]. Eur J Neurol. 2020;10.1111/ene.14361. doi:10.1111/ene.14361

5. University of California. 2020. University Of California Health Creates Centralized Data Set To Accelerate COVID-19 Research. [online] Available at: [Accessed 12 August 2020]