An Autopsy Review: "COVID Toes"

Area of Science:

• Dermatology
• Pathology
• Infectious Diseases

Background:

• Dermatologic manifestations of SARS-CoV-2 infection vary widely.
• COVID toes, or pernio-like lesions, are common in pediatric patients.
• Critically ill adults may present with ischemic digital lesions.

Observation:

• This study examined autopsy findings of cutaneous lesions in critically ill patients with SARS-CoV-2.
• Histopathology revealed thrombi in vessels of affected necrotic toes without significant inflammation.
• Systemic findings included popliteal artery thrombus and pulmonary emboli.

Findings:

• Critically ill adults with SARS-CoV-2 exhibit digital ischemia due to thromboembolic events.
• Pathological processes in skin lesions differ between pediatric and critically ill adult patients.
• Thrombi in digital vessels suggest an embolic origin for necrotic lesions.

Implications:

• Skin pathology in SARS-CoV-2 infection can reflect systemic thromboembolic processes.
• Understanding these diverse skin manifestations aids in diagnosing and managing COVID-19.
• Cutaneous lesions offer insights into the pathogenesis of severe systemic illness.