Coronavirus UK: Could bruises on your FEET be a symptom?

Bruising and lesions on the feet could be a sign of coronavirus, doctors in Spain suspect.

Patients with either purple chickenpox or chilblain-like marks on their toes have tested positive for the killer infection.

‘Numerous cases’ have been reported in Spain as well as Italy and France, as the disease continues to rage across Europe.

One of the first reported cases was a 13-year-old boy in Italy, whose lesions – initially thought to be caused by a spider bite – erupted and crusted over. 

Experts warn the mysterious symptom has primarily been spotted in children and teenagers.

But skin manifestations potentially caused by the virus were seen in one in five patients in an Italian hospital.

Typically the SARS-CoV-2 virus causes a persistent cough and fever. But recently studies have alerted diarrhoea, skin marks, testicular pain and a loss of taste and smell as ‘atypical’ signs. 

A large number of people who contract COVID-19 also experience headaches and dizziness, according to a study in China. 

Bruising and lesions on the feet could be a sign of coronavirus, doctors in Spain suspect. One of the first reported cases was a 13-year-old boy in Italy (pictured)

The teenager in Italy saw his lesions - initially thought to be caused by a spider bite - turn black and crusted. He and his family had symptoms of the coronavirus

The teenager in Italy saw his lesions – initially thought to be caused by a spider bite – turn black and crusted. He and his family had symptoms of the coronavirus 

The Spanish General Council of Official Podiatrist Colleges described patients who had purple lesions - very similar to those of chickenpox, measles or chilblains

The marks usually appear on the toes, but are not permanent

Experts warn the mysterious symptom has been spotted in children and teenagers the most

HEADACHES AND DIZZINESS A SIGN OF COVID-19 

More than a third of coronavirus patients develop neurological symptoms including headaches and dizziness, a study in China suggests.

Researchers analysed 214 patients hospitalised in Wuhan who tested positive for COVID-19. Most (60 per cent) were not seriously ill. 

Neurologic symptoms were seen in 36.4 per cent of patients and were more common in patients with severe infection – based on their respiratory symptoms.

The researchers said 13 per cent reported a headache, 17 per cent dizziness, 19 per cent nerve pain and 19 per cent muscle inflammation. 

Patients whose condition became severe went on to develop more intense neurological problems, including confusion, seizure and stroke.

All neurologic manifestations were reviewed and confirmed by two trained neurologists, the team wrote in their paper, published in the medical journal JAMA Neurology.

They explained that the neurological symptoms may be due to the way in which the virus attaches to cells in the body.

In January 2020, a receptor called ACE2 was identified as the ‘door’ into cells. The receptor is found in multiple human organs, ‘including nervous system and skeletal muscles’.  

The Spanish General Council of Official Podiatrist Colleges shared a statement revealing the ‘curious finding’.

It described patients who had purple lesions which are very similar to those of chickenpox, measles or chilblains – caused by the inflammation of tiny blood vessels.

The symptoms are ‘increasingly being detected in patients with COVID -19, especially children and adolescents’, according to podiatrists and dermatologists in Spain.

The marks have also been seen in adults, and normally heal without leaving a scar or similar.

The college, which has 7,500 members, said it was aware of similar findings in Italy and France. 

Medical experts in Spain are now collecting a database of people who have tested positive for the virus as well as having marks on their feet. 

And dermatologists from different Spanish health centers are leading the ‘COVID-Skin’ study, to categorise lesions which have been spotted in COVID-19 patients. 

The General Council of Official Colleges of Podiatrists opened a registry last Thursday, and told its members to ‘be very vigilant’.

It advised to quarantine children when such marks are spotted – but not to act with ‘unfounded alarmism’.

The International Federation of Podiatrists (FIP-IFP) reported one of the first cases of the symptom in a 13-year-old boy from Bari, southern Italy.

As it stands there is not enough 'scientific evidence' to support the link between marks on the feet and the coronavirus

One theory is that skin eruptions are caused by the closure of tiny blood vessels, which might be induced by the nervous system in response to the virus

Podiatrists and dermatologists have been advised to quarantine children when such marks are spotted – but not to act with ‘unfounded alarmism’

WHAT ARE THE COMMON AND ‘ATYPICAL’ SYMPTOMS OF COVID-19? 

The NHS website states that the symptoms of COVID-19 are:

  • A high temperature
  • A new, continuous cough

The World Health Organisation says other indicators include fatigue, aches and pains, a blocked nose, sore throat and diarrhoea. 

As the coronavirus infects millions globally, anecdotal and scientific studies have spotted some other ‘atypical’ symptoms:

Headaches and dizziness

A study in China found that 13 per cent of 214 patients hospitalised with COVID-19 had headaches, and 17 per cent reported dizziness. Overall more than a third reported neurological symptoms. 

The team explained the symptoms may be due to the way in which the virus attaches to cells in the body – through ACE2 receptors found in human organs and tissues within the nervous system. 

Loss of taste and smell

Data gathered by ENT UK, which represents ear, nose and throat specialists, suggests an inability to smell — and often taste — may be the very first symptom and can start within hours.

Those with the symptom are thought to be mostly healthy young adults whose immune systems react sufficiently to the virus to contain it within the nose, preventing it spreading to the lungs, where it can cause potentially fatal pneumonia.

Testicular pain

In February, scientists in China claimed the virus could attack the male reproductive organs – but there is not enough robust research to prove it.

The virus binds to the ACE2 receptors on cells which are found in abundance in the testes, and could lead to ’tissue damage’, the team speculated in their paper, which has not been peer-reviewed.

A 42-year-old man from America tested positive for the coronavirus after going to hospital with testicular pain, even though there were no signs of abnormalities.

Skin changes

A study of 88 coronavirus patients at Alessandro Manzoni Hospital in Lecco, northern Italy, found one in five complained of skin manifestations.

They had not taken any medications or drugs in the preceding 15 days, which could have caused a skin reaction. 

‘Numerous cases’ of chickenpox-like marks on the feet have been reported in Spain, Italy and France, mostly in children.  

The phenomenon is not well researched. But one theory is that skin eruptions are caused by the closure of tiny blood vessels, which might be induced by the nervous system in response to the virus.

Doctors attributed his violet, round lesions to a brown recluse spider bite, and sent him away with medication on March 8.

The teenager developed a fever, muscle pain, a headache and intense itching on the feet two days later.

After images of lesions on the feet of COVID-19 patients began circulating on Italian social media and among dermatologist sites, the doctors suspected the boy may have the disease. 

After studying his family’s medical history, they found his sister and mother had a fever, cough and difficulty breathing six days before he first had the lesions.

However, due to the severe outbreak of COVID-19 in Italy, the team admitted they hadn’t been able to test and follow up with the boy. 

As it stands there is not enough ‘scientific evidence’ to say for certain that small lesions on the feet are an official symptom – which was recognised by the college.

After all, it could be entirely coincidental that these marks, which look like blood blisters or bruises, occurred around the same time someone became unwell.

However, NHS GP Dr Daniel Gordon, based in London, told MailOnline: ‘It would be far from surprising if it turned out to be true that COVID-19 causes symptoms in the skin.

‘Many viruses cause skin rashes and marks. Viruses tend to affect multiple parts of the body rather than just one system, although in the case of COVID-19 it is certainly the lungs that are most heavily hit. 

‘These findings are just case reports at present, and more work will need to be done by scientists to find out if there is a significant association.’ 

One theory is that skin eruptions are caused by the closure of tiny blood vessels, which might be induced by the nervous system in response to the virus.

Dr Randy Jacobs, an assistant clinical professor of dermatology at the University of California, said COVID-19 can ‘feature signs of small blood vessel occlusion’ – clotting of the blood  – according to The Hospitalist.

He said: ‘Many have wondered if COVID-19 presents with any particular skin changes. The answer is yes.’

One study of 88 patients at Alessandro Manzoni Hospital in Lecco, northern Italy, found 20 per cent complained of skin manifestations.

They had not taken any medications or drugs in the preceding 15 days, which could have caused a skin reaction. 

Fourteen patients had a reddish rash, three had hives, and one patient had chickenpox-like marks.

These skin manifestations ‘are similar to cutaneous involvement occurring during common viral infections’, author of the report Dr Sebastiano Recalcati said.

Doctors in Thailand – the first country outside of China to report a coronavirus case – have raised concerns that skin problems potentially caused by the coronavirus will be wrongly diagnosed as something else.

They described how a Thai man with COVID-19 was first falsely diagnosed with dengue fever because he had the typical tiny purple, red, or brown spots on the skin.