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Epidemiol Infect ; 149: e145, 2021 06 16.
Article in English | MEDLINE | ID: covidwho-1392726


The appearance on the skin of herpes virus lesions, concomitantly with the coronavirus disease 2019 (COVID-19) pandemic, leads us to suspect an underlying infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Diagnostic reverse transcriptase polymerase chain reaction tests and immunoglobulin M (IgM) and IgG seroconversion studies have therefore been carried out. We present three cases of herpes virus infections in immunocompetent patients: one of the infections was herpes simplex 1 in a 40-year-old woman, and the other two were herpes varicella-zoster infections in a 62-year-old man and a 25-year-old woman. The patients were in the care of the southern health district of Seville of the SAS (Andalusian Health Service) during the Spanish state of alarm over the COVID-19 pandemic. The SARS-CoV-2 infection was confirmed in only one of the three cases. In this study, we briefly review the etiopathogenic role of the COVID-19 pandemic situation, whereby immunodeficiencies are generated that favour the appearance of other viral infections, such as herpes virus infections.

COVID-19/complications , Herpes Simplex/etiology , Herpes Zoster/etiology , Herpesvirus 3, Human/physiology , Simplexvirus/physiology , Virus Activation , Adult , COVID-19/epidemiology , COVID-19/virology , Female , Herpes Simplex/diagnosis , Herpes Simplex/virology , Herpes Zoster/diagnosis , Herpes Zoster/virology , Humans , Male , Middle Aged , Risk Factors , Spain/epidemiology
Cutis ; 106(6): 318-320, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1225960


Varicella-zoster virus infection causes 2 distinct forms of disease: varicella (commonly known as chickenpox) and herpes zoster (HZ)(commonly known as shingles). Primary varicella-zoster virus infection results in the diffuse vesicular rash that is characteristic of chickenpox. Following primary infection, varicella-zoster virus remains dormant in the dorsal root ganglia. This latent phase usually lasts for several decades before reactivation occurs. Varicella-zoster virus reactivation normally presents as HZ in middle-aged adults. A number of cutaneous skin manifestations have appeared in relation to the newly diagnosed coronavirus disease 2019 (COVID-19) pandemic and continue to emerge every day. We report a case of HZ complication in a COVID-19-positive woman who was 27 weeks pregnant.

COVID-19/complications , Herpes Zoster/diagnosis , Pregnancy Complications, Infectious/virology , Virus Activation , Adult , COVID-19/diagnosis , Female , Herpes Zoster/virology , Herpesvirus 3, Human/isolation & purification , Humans , Pregnancy
Rheumatology (Oxford) ; 60(SI): SI90-SI95, 2021 10 09.
Article in English | MEDLINE | ID: covidwho-1180634


OBJECTIVES: As global vaccination campaigns against COVID-19 disease commence, vaccine safety needs to be closely assessed. The safety profile of mRNA-based vaccines in patients with autoimmune inflammatory rheumatic diseases (AIIRD) is unknown. The objective of this report is to raise awareness of reactivation of herpes zoster (HZ) following the BNT162b2 mRNA vaccination in patients with AIIRD. METHODS: The safety of the BNT162b2 mRNA vaccination was assessed in an observational study monitoring post-vaccination adverse effects in patients with AIIRD (n = 491) and controls (n = 99), conducted in two rheumatology departments in Israel. RESULTS: The prevalence of HZ was 1.2% (n = 6) in patients with AIIRD compared with none in controls. Six female patients aged 49 ± 11 years with stable AIIRD: RA (n = 4), Sjogren's syndrome (n = 1), and undifferentiated connective disease (n = 1), developed the first in a lifetime event of HZ within a short time after the first vaccine dose in five cases and after the second vaccine dose in one case. In the majority of cases, HZ infection was mild, except a case of HZ ophthalmicus, without corneal involvement, in an RA patient treated with tofacitinib. There were no cases of disseminated HZ disease or postherpetic neuralgia. All but one patient received antiviral treatment with a resolution of HZ-related symptoms up to 6 weeks. Five patients completed the second vaccine dose without other adverse effects. CONCLUSION: Epidemiologic studies on the safety of the mRNA-based COVID-19 vaccines in patients with AIIRD are needed to clarify the association between the BNT162b2 mRNA vaccination and reactivation of zoster.

Autoimmune Diseases/virology , COVID-19 Vaccines/adverse effects , COVID-19/prevention & control , Herpes Zoster/chemically induced , Herpesvirus 3, Human/physiology , Rheumatic Diseases/virology , Virus Activation/drug effects , Adult , COVID-19/immunology , Female , Herpes Zoster/virology , Humans , Middle Aged , SARS-CoV-2