Exanthema on background of COVID-19 in children: is additional therapy needed?

Goal. To assess the frequency of skin manifestations in children, the need and effectiveness of pathogenetic therapy for skin rash associated with COVID-19 in children. Materials and methods. The data of the case histories of 55 children aged 8 months to 18 years with confirmed infection caused by the SARS-CoV-2 virus were analyzed. Of these, 36 were hospitalized with a diagnosis of community-acquired pneumonia of coronavirus etiology (SARS-CoV-2 virus identified) in the children’s infectious diseases department of the Mytishchi City Clinical Hospital. Another 19 children received treatment on an outpatient basis for rhinopharyngitis and/or bronchitis or tracheobronchitis against the background of laboratory-confirmed COVID-19. In most cases, there was a moderate course (64 % or 35 children) and a mild form (36 % or 20 patients). The SARS-CoV-2 virus was identified in pharyngeal and nasal swabs using the standard polymerase chain reaction method. All patients received therapy in accordance with the current temporary guidelines, and if indicated, other drugs. Results. In 7 (13 %) children in the acute period of coronavirus infection, urticarial rashes were found, in 3 (5 %) – maculopapular. Itching was mild in most cases. According to children and (or) their parents, elements of exanthema appeared in the period from 1st to 8th days from the time the first symptoms of COVID-19 developed. The rash persisted for 1 to 7 days. In 2 children who had a pronounced widespread exanthema against the background of rhinopharyngitis in the absence of pulmonary lesions, a prolonged period of significant astheno-vegetative disorders was noted. In one of the observed children on day 1, exanthema was the only manifestation of coronavirus infection. When prescribing additional antihistamines, there was no significant result. When using enterosorbents (Zosterin Ultra 30 or 60), the appearance of new elements stopped, the rash regressed within 2–5 days. Conclusions. 18 % of children treated for mild to moderate COVID-19 developed skin rashes. Exanthema with coronavirus infection in children should be considered one of the symptoms of the disease. Despite the more frequent detection of urticaria-type rash, no direct relationship with allergic history has been identified. The use of enterosorbents contributes to the relief of exanthema.

children, pruritus, coronavirus, urticaria, pneumonia, rash, urticaria, rash, exanthema, COVID-19, SARS-CoV-2

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