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Bell’s palsy and urticarial rash as fi rst manifestations of COVID-19 infection

https://doi.org/10.30629/2658-7947-2021-26-3-46-50

Abstract

The new coronavirus SARS-CoV-2 is a single-stranded RNA virus of the Coronaviridae family and is clinically manifest with respiratory symptoms. However, patients have been described with symptoms and complications from the nervous system, as well as skin manifestations in the form of various rashes. In our clinical case of coronavirus infection (SARS-CoV-2), this is pneumonia with respiratory failure of the 1st degree, moderate severity and Bell’s palsy in combination with skin rashes in the form of an urticarial rash in a 58-year-old woman. Clinical features of cutaneous and neurological symptoms were prior to the development of respiratory symptoms. The presented clinical case showed that COVID-19, before the development of respiratory symptoms, can manifest itself with peripheral paralysis of the facial nerve and be combined with skin rashes, which can complicate the timely diagnosis of a viral disease.

About the Authors

Kh. P. Derevyanko
Bashkir State Medical University
Russian Federation

Ufa



L. N. Khusainova
Bashkir State Medical University
Russian Federation

Ufa



M. M. Khafizov
Bashkir State Medical University
Russian Federation

Ufa



A. Sh. Sattarova
Bashkir State Medical University
Russian Federation

Ufa



Sh. M. Safin
Bashkir State Medical University
Russian Federation

Ufa



References

1. World Health Organization. 11 march 2020. httph://www.int/ru/dg/speeches/detail/who-director-general-s-opening-remarks-atthe-media-briefingon-covid-19

2. Guo Y.R., Cao Q.D., Hong Z.S., Tan Y.Y., Chen S.D., Jin H.J. et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak–an update on the status. Mil. Med. Res. 2020;13:11. https://doi.org/10.1186/s40779-020-00240-0

3. Zhao Y., Zhao Z., Wang Y., Zhou Y., Ma Y., Zuo W. Single-cell RNA expression profi ling of ACE2, the putative receptor of Wuhan 2019-nCov. bioRxiv published online, 2020. https://doi.org/10.1101/2020.01.26.919985

4. Zhai P., Ding Y., Wu X., Long J., Zhong Y., Li Y. The epidemiology, diagnosis and treatment of COVID-19. Int. J. Antimicrob. Agents. 2020;28:105955. https://doi.org/10.1016/j.ijantimicag.2020.105955

5. Carlos W.G., Dela Cruz C.S., Cao B., Pasnick S., Jamil S. Novel Wuhan (2019-nCoV) coronavirus. Am. J. Respir. Crit. Care Med. 2020;201:7–8. https://doi.org/10.1164/rccm.2014P7

6. Rothan H.A., Byrareddy S.N. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J. Autoimmun. 2020;109:12–15. https://doi.org/10.1016/j.jaut.2020.102433

7. Belopasov V.V., Yachou Y., Samoilova E.M., Baklaushev V.P. The nervous system damage in COVID-19. Journal of Clinical Practice. 2020;11(2):60–80. (In Russian). https://doi.org/10.17816/clinpract34851

8. Ternovyh I.K., Topuzova M.P., Chaykovskaya A.D., Isabekova P.S., Alekseeva T.M. Neurological manifestations and complications in patients with COVID-19. Translational Medicine. 2020;7(3):21–29. (In Russian) https://doi.org/10.18705/2311-4495-2020-7-3-21-29.

9. Chen N., Zhou M., Dong X., Qu J., Gong F., Han Y. et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. Lancet. 2020;395:507–513. https://doi.org/10.1016/S0140-6736 (20)30211-7

10. Guan W., Ni Z., Hu Y., Liang W., Ou C., He J. et al. Clinical characteristics of 2019 novel coronavirus infection in China. https://doi.org/10.1101/2020.02.06.20020974

11. Chen C., Dong Y., Kang J., Lou Sh., Wan F., Liu H. et al. Asymptomatic novel coronavirus pneumonia presenting as acute cerebral infarction: case report and review of the literature. Chin. J. Emerg. Med. 2020,29 (00):E017–E017. https://doi.org/10.3760/cma.j.issn.1671-0282.2020022.007

12. Zhao N., Fu L. The fi rst case report of 2019-nCoV pneumonia complicated with encephalitis. Available from: http://china.caixin.com/2020-03-09/101525701.html

13. Deng S.Q., Peng H.J. Characteristics of and public health responses to the coronavirus disease 2019 outbreak in China. J. Clin. Med. 2020;9(2):575. https://doi.org/10.3390/jcm9020575

14. Peitersen E. Bell’s Palsy: The spontaneous course of 2500 peripheral facial nerve palsies of diff erent etiologies. Acta Oto-Laryngologica. 2002;7:4–30. PMID:12482166

15. Greco A., Gallo A., Fusconi M., Marinelli C., Macri G.F. Vincentiis M. Bell’s palsy and autoimmunity. Autoimmunity reviews. 2012;12:323–328. https://doi.org/10.1016/j.autrev.2012.05.008

16. Murakami S., Mizobuchi M., Nakashiro Y., Doi T., Hato N., Yanagihara N. Bell palsy and herpes simplex virus: identifi cation of viral DNA in endoneurial fl uid and muscle. Ann. Intern. Med. 1996124 (1Pt.1):27–30. https://doi.org/10.7326/0003-4819-124-1_part_1-199601010-00005

17. Minnerop M., Herbst M., Fimmers R., Kaabar P., Matz B., Klockgether T. et al. Bell’s palsy: combined treatment of famciclovir and prednisone is superior to prednisone alone. J. Neurol. 2008;255:1726–1730. https://doi.org/10.1007/s00415-008-0008-6

18. Rahimi H., Tehranchinia Z. A Comprehensive Review of Cutaneous Manifestations Associated with COVID-19. BioMed Research International. 2020;1236520:8. https://doi.org/10.1155/2020/1236520

19. Galván Casas C., Català A., Carretero Hernández G., Rodríguez‐ Jiménez P., Fernández Nieto D., Rodríguez‐Villa Lario A. et al. Classifi cation of the cutaneous manifestations of COVID‐19: a rapid prospective nationwide consensus study in Spain with 375 cases. Br. J. Dermatol. 2020;183(1):71–77. Epub 2020 Jun 10. https://doi.org/10.1111/bjd.19163

20. Xu J., Zhong S., Liu J., Li L., Li Y., Wu X. et al. Detection of severe acute respiratory syndrome coronavirus in the brain: potential role of the chemokine mig in pathogenesis. Clin. Infect. Dis. 2005;41(8):1089–1096. https://doi.org/10.1086/444461

21. Lau K.K., Yu W.C., Chu C.M., Lau S.T., Sheng B., Yuen K.Y. Possible central nervous system infection by SARS coronavirus. Emerg. Infect. Dis. 2004;10(2):342–344. https://doi.org/10.3201/eid1002.030638

22. Baig A.M., Khaleeq A., Ali U., Syeda H. Evidence of the COVID-19 virus targeting the CNS: tissue distribution, hostvirus interaction, and proposed neurotropic mechanisms. ACS Chem. Neurosci. 2020;11(7):995–998. https://doi.org/10.1021/acschemneuro.0c00122

23. Li Y.C., Bai W.Z., Hashikawa T. The neuroinvasive potential of SARS-CoV2 may be at least partially responsible for the respiratory failure of COVID-19 patients. J. Med. Virol. 2020;92:552–555. https://doi.org/10.1002/jmv.25728

24. Mao L., Jin H., Wang M., Hu Y., Chen S., He Q. et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020;77(suppl 6):683–90. https://doi.org/10.1001/jamaneurol.2020.1127

25. Ellul M.A., Benjamin L., Singh B., Lant S., Michael B.D., Easton A. et al. Neurological associations of COVID-19. Lancet Neurol. 2020;19:767–83. Published Online July 2, 2020 https://doi.org/10.1016/S1474-4422 (20)30221-0

26. Homma Y., Watanabe M., Inoue K., Moritaka T. Coronavirus Disease-19 Pneumonia with Facial Nerve Palsy and Olfactory Disturbance. Intern. Med. 2020;59(14):1773–1775. https://doi.org/10.2169/internalmedicine.5014-20

27. Islamoglu Y., Celik B., Kiris M. Facial paralysis as the only symptom of COVID-19: A prospective study. Am. J. Otolaryngol. 202142 (4):102956. Published online 2021 Feb 10. https://doi.org/10.1016/j.amjoto.2021.102956

28. Figueiredo R., Falcão V., Pinto M.J., Ramalho C. Peripheral facial paralysis as presenting symptom of COVID-19 in a pregnant woman. BMJ Case Rep. 2020;13(8):e237146. https://doi.org/10.1136/bcr-2020-237146

29. Theophanous C., Santoro J., Itani R. Bell’s palsy in a pediatric patient with hyper IgM syndrome and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Brain Dev. 2020:S0387-7604 (20)30260-6. https://doi.org/10.1016/j.braindev.2020.08.017

30. Farber M.A., Farber F.M. Nevropatii licevogo nerva. Alma-Ata: Gylym, 1991:168 (In Russian)

31. Yanagihara N., Mori H., Kozawa T., Nakamura K., Kita M. Bell’s Palsy: Nonrecurrent v Recurrent and Unilateral v Bilateral. Arch. Otolaryngol. 1984;110(6):374–377. https://doi.org/10.1001/archotol.1984.00800320028006

32. McCormick D.P. Herpes-simplex virus as a cause of Bell’s palsy. Lancet. 1972;1:937–939. https://doi.org/10.1016/s0140-6736 (72)91499-7

33. Steiner I. Human herpes viruses latent infection in the nervous system. Immunol. Rev. 1996;152:157–173. https://doi.org/10.1111/j.1600-065x.1996.tb00915.x

34. Leibowitz U. Epidemic incidence of Bell’s palsy. Brain. 1969;92:109–114. https://doi.org/10.1093/brain/92.1.109

35. Liston S.L., Kleid M.S. Histopathology of Bell’s palsy. Laryngoscope. 1989;99:23–26. https://doi.org/10.1288/00005537-198901000-00006

36. Ji X., Zhang C., Zhai Y., Zhang Z., Zhang C., Xue Y. et al. TWIRLS, an automated topic-wise inference method based on massive literature, suggests a possible mechanism via ACE2 for the pathological changes in the human host after coronavirus infection. https://doi.org/10.1101/2020.02.24.20025437

37. Zhang W., Xu L., Luo T., Wu F., Zhao B., Li X. The etiology of Bell’s palsy: a review. J. Neurol. 2019;267:1896–905. https://doi.org/10.1007/s00415-019-09282-4

38. Grattan C.E.H., Marsland A.M. Urticaria: Rook’s Textbook of Dermatology [Internet. Chichester, UK: John Wiley & Sons, Ltd, 2016:1–21].

39. Dvornikov A.S., Silin A.A., Gaydina T.A., Larina V.N., Skripkina P.A., Kiva E.V. The Dermatological Manifestations in the Coronavirus Infection COVID-19. The Russian Archives of Internal Medicine. 2020;10(6):422–429. (In Russian). https://doi.org/10.20514/2226-6704-2020-10-6-422-429.

40. Wedi B., Raap U., Wieczorek D., Kapp A. Urticaria and infections. Allergy Asthma Clin. Immunol. 2009;5(1):10. https://doi.org/10.1186/1710-1492-5-10

41. Hamming I., Timens W., Bulthuis M.L.C., Lely A.T., Navis G.J., van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A fi rst step in understanding SARS pathogenesis. J. Pathol. 2004;203(2):631–637. https://doi.org/10.1002/path.1570

42. Mehregan D.R., Gibson L.E. Pathophysiology of urticarial vasculitis. Arch. Dermatol. 1998;134:88–89. https://doi.org/10.1001/archderm.134.1.88

43. Tolouian R., Zununi Vahed S., Ghiyasvand S., Tolouian A., Ardalan M.R. COVID-19 interactions with angiotensin-converting enzyme 2 (ACE2) and the kinin system; looking at a potential treatment. J. Renal. Inj. Prev. 2020;9(2):e19. https://doi.org/10.34172/jrip.2020.19

44. Nishad A.A.N., Arulmoly K., Priyankara S.A.S., Abeysundara P.K. A forgotten cause of allergy at ER that is still diffi cult to diagnose and treat at poor resource setting: angioedema after using angiotensin converting enzyme inhibitors for 4 years. Case Reports Immunol. 2019;2019:1676391. Published online 2019 Jan 2. https://doi.org/10.1155/2019/1676391

45. Hofman Z.L.M., van den Elzen M.T., Kuijpers J., de Maat S., Hack C.E., Knulst A.C. et al. Evidence for bradykinin release in chronic spontaneous urticaria. Clin. Exp. Allergy. 2020;50(3):343–351. https://doi.org/10.1111/cea.13558

46. Coenraads P.-J., Gonçalo M. Skin diseases with high public health impact. contact dermatitis. Eur. J. Dermatol. 2007;17:564–5. https://doi.org/10.1684/ejd.2007.0299

47. Olasz E.B., Yancey K.B. Bullous pemphigoid and related subepidermal autoimmune blistering diseases. Curr. Dir. Autoimmun. 2008;10:141–66. https://doi.org/10.1159/000131452

48. Mehregan D.R., Hall M.J., Gibson L.E. Urticarial vasculitis: a histopathologic and clinical review of 72 cases. J. Am. Acad. Dermatol. 1992;26(3Pt.2):441–8. https://doi.org/10.1016/0190-9622(92)70069-r

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For citations:


Derevyanko Kh.P., Khusainova L.N., Khafizov M.M., Sattarova A.Sh., Safin Sh.M. Bell’s palsy and urticarial rash as fi rst manifestations of COVID-19 infection. Russian neurological journal. 2021;26(3):46-50. https://doi.org/10.30629/2658-7947-2021-26-3-46-50

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