Telogen Effluvium as Sequela of COVID-19 in Patients from Central India: A Retrospective Observational Study

ABSTRACT

Introduction: Corona virus disease has several dermatological symptoms. Telogen effluvium is one of them. The present study presents a case series of post COVID Telogen effluvium from Central India region. Material and Method: This retrospective observational study included 72 patients (61 females & 11males), aged 29 to 62 years (median 49 yrs). The patient’s demography, history of hair fall, signs and symptoms, co morbidities and the treatment received for COVID-19 infection, Psychological perceived stress score, triggering factors for Telogen effluvium, Vitamin B12, Vitamin D and Ferritin levels were recorded & analysed. Result: The included patients were suffering from at least one co morbidity. Thirty patients had severe COVID-19 infection and were hospitalized. Psychological perceived stress score was low (12) in two, moderate (16-24) in twenty and high (29-38) in fifty patients. Vitamin B12 was low in twelve and Ferritin in ten patients. Seventy patients (97.2%) had positive hair pull test and 69 (95.8 %) had diffuse loss of hair. Discussion: Post covid Telogen effluvium was seen generally in females, and in middle aged. Most, 70/72 had moderate to severe psychological stress, Psychological perceived stress score was more than 16. Patients reported 2.2 to 6 months (median 3.5 months) after COVID-19 infection. Most 69 (95.8%) had diffuse hair loss. Post Covid patients may have several triggering factors for Telogen effluvium like psychological stress, nutritional deficiency or the drugs (heparin). Conclusion: Post Covid Telogen effluvium could be triggered by psychological stress, nutritional deficiencies (Vitamin B12, Iron) or drugs (heparin). Such cases could be managed by identification of triggering factors, proper counselling, high protein diet with vitamin supplementation.