dgkh000372 10.3205/dgkh000372 urn:nbn:de:0183-dgkh0003721 Letter to the Editor Cutane Hyperästhesie bei COVID-19 Infektion? Bestätigung eines kürzlichen Fallberichts Harsch Harsch Igor Alexander IA Prof. Dr. M.D.

Department of Internal Medicine II, Thuringia Clinic Saalfeld "Georgius Agricola", Rainweg 68, 07318 Saalfeld/Saale, Germany, Phone: +49 3671/541569, Fax: +49 3671/541403Department of Internal Medicine II, Thuringia Clinic Saalfeld “Georgius Agricola”, Saalfeld/Saale, Germany

iharsch@thueringen-kliniken.de author Atudorei Atudorei Irina I

Department of Dermatology, Thuringia Clinic “Georgius Agricola”, Saalfeld/Saale, Germany

author Frank Frank Kathrin K

Department of Dermatology, Thuringia Clinic “Georgius Agricola”, Saalfeld/Saale, Germany

author German Medical Science GMS Publishing House

Düsseldorf

610 20210112 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). 2196-5226 16 GMS Hygiene and Infection Control GMS Hyg Infect Control 01 Dear Editor,One of the first neurological symptoms of a COVID-19 infection that has been frequently described is the loss of smell and taste. A large number of neurological problems following the infection have been reported to date . As the duration of the pandemic and the number of infections increases, reports of rarer complications, possibly in connection with the disease, are also being published, for which an etiopathological connection to COVID-19 infection has not been proven, but for which the close temporal relationship nevertheless suggests causality. Cutaneous hyperesthesia was only recently reported in two patients. Krajewski et al. reported on two 40-year-old patients in whom this phenomenon had occurred in immediate temporal relationship to a COVID-19 infection and lasted for about 10 days. One patient was, however, also treated with diclofenac and azithromycin. We describe the case of a 69-year-old female patient with a moderate COVID-19 infection according to the NIH definition, who was admitted to our clinic in November 2020 and in whom the phenomenon of considerable cutaneous hypersensitivity occurred on the day of admission, especially in the abdomen and legs. Any form of touch intensified this sensation. Further neurological examination showed no pathology. Cutaneous inspection revealed no signs of shingles or other abnormalities. The patient suffered from hypertension and dyslipidemia, prior and ongoing treatment (for several years) consisted of Amlodipin, Bisoprolol, Ramipril and Simvastatin. To rule out other possible reasons for hyperesthesia, we measured the Hba1c (5.7 %) and the Vitamin B 12 level (714 ng/l, normal range 197–866 ng/l), both of which were within the normal range. The hypersensitivity spontaneously resolved 8 days later. The timeline of this symptom in our case is thus comparable to the timespan reported by Krajewski et al. .This symptom seems to be rare; at the time of submission of the manuscript, 105 patients with COVID-19 infection had been treated in our clinic; no patient had previously reported this symptom. However, in more severe courses of the disease, this pathology may have been disregarded. The two cases previously reported also seem to meet the NIH criteria for a “moderate” COVID-19 infection. It remains to be observed whether further case reports will be published in this regard, which would allow cutaneous hypersensitivity to be assigned to COVID-19 infection with greater certainty. NotesCompeting interestsThe authors declare that they have no competing interests.FundingThere was no financial support.Patient’s consentThe patient gave informed consent to the reporting of her case. Ellul MA Benjamin L Singh B Lant S Michael BD Easton A Kneen R Defres S Sejvar J Solomon T Neurological associations of COVID-19 2020 Lancet Neurol 767-783 Ellul MA, Benjamin L, Singh B, Lant S, Michael BD, Easton A, Kneen R, Defres S, Sejvar J, Solomon T. Neurological associations of COVID-19. Lancet Neurol. 2020 Sep;19(9):767-783. DOI: 10.1016/S1474-4422(20)30221-0 https://doi.org/10.1016/S1474-4422(20)30221-0 Krajewski PK Szepietowski JC Maj J Cutaneous hyperesthesia: A novel manifestation of COVID-19 2020 Brain Behav Immun 188 Krajewski PK, Szepietowski JC, Maj J. Cutaneous hyperesthesia: A novel manifestation of COVID-19. Brain Behav Immun. 2020 Jul;87:188. DOI: 10.1016/j.bbi.2020.05.064 https://doi.org/10.1016/j.bbi.2020.05.064 National Institute of Health COVID-19 Treatment Guidelines: Clinical Presentation of People with SARS-CoV-2 Infection. Last Updated: October 9, 2020. National Institute of Health. COVID-19 Treatment Guidelines: Clinical Presentation of People with SARS-CoV-2 Infection. Last Updated: October 9, 2020. Availabe from: https://www.covid19treatmentguidelines.nih.gov/overview/clinical-presentation https://www.covid19treatmentguidelines.nih.gov/overview/clinical-presentation 0 0 0 0