Clinical characteristics and outcomes of patients with Herpes Zoster Infection in the context of SARS-CoV-2 infection. A case report and a systematic review

Kapoor D., Kumar B., Singhal M., Idris F.H., Gandhi S.M., Bhattachrya S., Prajapati B.G., Maheshwari R.

Leeyaphan C., Jirawattanadon P., Bunyaratavej S., Panjapakkul W., Hutachoke T., Nanchaipruek Y., Phumariyapong P.

Background. Herpes zoster (HZ) has been observed to occur after COVID-19 infection and vaccination; however, knowledge regarding the demographic data, clinical presentations, and treatment outcomes of HZ is limited. Objective. To compare the demographic data, clinical manifestations, treatments, and outcomes of patients with and without HZ within 14 days of COVID-19 infection or vaccination. Methods. This prospective cohort study involving patients diagnosed with cutaneous HZ was conducted at a dermatology clinic from October 2021 to January 2023. Results. Among a total of 232 patients with HZ, the median age was 62.0 years and 59.1% were female. HZ developed in 23 (9.9%) and four (1.7%) patients after COVID-19 vaccination and infection, respectively. The mean duration from vaccination and the median duration from infection to HZ onset were 5.7 and 8.5 days, respectively. The proportion of female patients was significantly higher in the group of patients with COVID-19 vaccination or infection than in those without such a history (P = 0.035). Patients who developed HZ following the recent COVID-19 infection had a median age of 42.5 years, which was lower than that of the other groups. Dissemination occurred in 8.7% of the patients after COVID-19 vaccination. HZ recurrence was reported in five cases, of which 80% had been vaccinated or infected with COVID-19 during the previous 21 days. All patients had similar durations of antiviral treatment, crust-off time, and duration of neuralgia. Conclusions. HZ after COVID-19 vaccination is more frequently observed in females, while HZ after COVID-19 infection tends to occur in younger patients. Disseminated HZ is more common in patients recently vaccinated against COVID-19. COVID-19 vaccination or infection may trigger recurrent HZ infection.

Getzler I.E., Vered S., Gavze R.P., Adler L., Oved M.

AbstractSince the COVID‐19 outbreak, there have been numerous reports concerning COVID‐19 skin manifestations. Debate has ensued as to whether these lesions are unique or represent a form of viral reactivation. The aim of this research was to compare the incidence of herpetic skin lesions between a COVID‐19 group, a Sars‐CoV‐2 mRNA vaccination group, and their respective controls, taking into account their Herpesviridae carrier status. To achieve this goal, the Maccabi Healthcare Services' database was scanned and cohorts of both verified COVID‐19 and mRNA vaccinated patients were extracted and matched to random control groups. Patients with a documented occurrence of any Herpesviridae infection that occurred prior to the studied ‘event’ (i.e., COVID‐19 or mRNA vaccination) were regarded as carriers of Herpesviridae. A COVID‐19‐related or vaccination‐related lesion was defined as a clinically diagnosed herpetic lesion appearing 1 month after the index date. In the COVID‐19 cohort, there was an insignificant difference in herpetic lesion incidence between the groups. However, logistic regression demonstrated that the interaction of COVID‐19 with the Herpesviridae carrier status was statistically significant. For the vaccination cohort, the data showed statistically significant differences between groups in herpetic frequencies, which manifested as an almost 2‐fold odds of developing a herpetic lesion. In conclusion, following the analysis of two large cohorts, there is evidence to support the contribution of both COVID‐19 and the mRNA vaccine to the reactivation of Herpesviridae. Our results diminish the idea that COVID‐19 has unique, herpetic‐like lesions.

Maulida P.T., Kim J.W., Jung M.C.

The objectives of this study are to examine the feasibility of the releasable asbestos sampler (RAS) equipment for laboratory tests as an alternative to activity-based sampling (ABS), and to apply the equipment controlled by wind velocity and water contents in the field to asbestos-contaminated soils. Two asbestos-contaminated mines (the Jecheon mine and the Jongmin-ri mine) were selected. At each mine, 21 surface soils (0~15 cm) were sampled, the asbestos concentrations were analyzed, and then three representative sites, containing 0.25%, 0.50%, and 0.75% of asbestos in soils, were chosen to evaluate the amount of releasable asbestos by the modified RAS with wind velocity and water contents. The results showed that the levels of releasable asbestos from soil to air increased with higher wind velocities and lower water content. In addition, the application of risk assessment of releasable asbestos in the soils as an alternative to the activity-based sampling (ABS) method was established at each site, and an estimation of the excess lifetime cancer risk (ELCR) was also calculated. According to the calculation, the estimated ELCR values did not exceed the threshold value (1 × 10−4) in the Jecheon mine for all the soils, while some samples from the Jongmin-ri mine exceeded the threshold value. Therefore, proper remediation work is needed to control friable asbestos from soils to air in the vicinity of the mines.