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Atypical cutaneous and musculoskeletal manifestation of SARS-CoV-2: ‘COVID-19 toes’ and spasticity in a 48-year-old woman
  1. Avery Kopacz,
  2. Cameron Ludwig and
  3. Michelle Tarbox
  1. Texas Tech University Health Science Center School of Medicine, Lubbock, Texas, USA
  1. Correspondence to Dr Avery Kopacz; avery.kopacz{at}ttuhsc.edu

Abstract

Establishing accurate symptomatology associated with novel diseases such as COVID-19 is a crucial component of early identification and screening. This case report identifies an adult patient with a history of clotting dysfunction presenting with rare cutaneous manifestations of COVID-19, known as ‘COVID-19 toes’', previously described predominantly in children. Additionally, this patient presented with possible COVID-associated muscle spasticity of the lower limbs, as well as a prolonged and atypical timeline of COVID-19 infection. The rare occurrence of ‘COVID-19 toes’' in this adult patient suggests that her medical history could have predisposed her to this symptom. This supports the coagulopathic hypothesis of this manifestation of COVID-19 and provides possible screening questions for patients with a similar history who might be exposed to the virus. Additionally, nervous system complaints associated with this disease are rare and understudied, so this novel symptom may also provide insight into this aspect of SARS-CoV-2.

  • COVID-19
  • cardiovascular medicine
  • lipid disorders
  • infectious diseases
  • pain (neurology)

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Footnotes

  • Contributors AK and CL wrote, edited and reviewed the manuscript. MT provided supervision and manuscript review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.