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Characteristics of telogen effluvium in COVID-19 in western Iran (2020).

Khaled Babaei, Hossein Kavoussi, Mansour Rezaei, Reza Kavoussi
Other Anais brasileiros de dermatologia 2021 26 citations
PubMed DOI CC-BY PDF
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Study Design

Type d'étude
cross-sectional observational study
Taille de l'échantillon
526
Intervention
Characteristics of telogen effluvium in COVID-19 in western Iran (2020). None
Comparateur
Placebo
Direction de l'effet
Neutral
Risque de biais
High

Abstract

BACKGROUND: Although COVID-19 pandemic significantly induces mortality, many of the patients who recovered present other medical problems such as alopecias. Telogen effluvium is a common alopecia that is usually related to previous events such as acute febrile diseases, including COVID-19. OBJECTIVE: To evaluate the characteristics of telogen effluvium in COVID-19. METHOD: This cross-sectional study was carried out on 526 patients with documented telogen effluvium that recovered from COVID-19. Demographic data, concurrent alopecia, associated diseases, and COVID-19 severity were recorded. Data were analyzed by appropriate statistical methods. RESULTS: The mean age of the 526 patients (410 females, 116 males) was 30.97 ± 9.592 years, with 7.65 ± 1.739 weeks of mean time of alopecia onset. Vitamin D deficiency (24.3%), androgenetic alopecia (78.2%), and grade III COVID-19 severity were the most common findings. Alopecia onset was significantly earlier in the younger age group, females, in hypothyroidism, and more severe coronavirus infection. Higher grade coronavirus infection was significantly seen in males, higher ages, earlier onset, and androgenic alopecia. STUDY LIMITATIONS: Performing a single-center study and considering limited variables. CONCLUSION: Although Coronavirus 2 infection can be an important factor in telogen effluvium induction, other factors such as associated diseases, drug intake and emotional stress may also be involved. In the cases of early onset of alopecia, concomitant diseases such as hypothyroidism and severe coronavirus infection can occur, thus, the presence of various factors in telogen effluvium induction should be considered.

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Tables

Table 1

VariablesResults
Mean age of patients (years)30.97 ± 9.592
Mean duration of disease onset (week)7.65 ± 1.739
Sex n (%)Female410 (77.9%)
Male116 (22.1%)
Associated diseases n (%)Yes181 (34.4%)
No345 (65.6%)
Type of associated diseases or laboratory findings n (%)Vitamin D deficiency44 (24.3%)
Elevated ESR38 (21.0%)
Hypothyroidism38 (21.0%)
Diabetes36 (19.9%)
Iron deficiency anemia25 (13.8%)
Smoking n (%)Yes57 (10.8%)
No469 (89.2%)
Alcohol consumption n (%)Yes43 (8.2%)
No483 (91.8%)
Concurrent alopecia n (%)Yes147 (27.9%)
No379 (72.1%)
Type of concurrent alopecia n (%)Androgenic alopecia115 (78.2%)
Alopecia areata28 (19.0%)
Cicatricial alopecia4 (2.7%)
Grading of COVID-19 n (%)Grade I100 (19.0%)
Grade II150 (28.5%)
Grade III193 (36.7%)
Grade IV83 (15.8%)
Grade V0 (0.0%)
Total number of patients526 (100.0%)

Table 2

VariablesGrading of COVID-19
P valueMDHLOAIP value
IIIIIIIV
Sex:
Female83(20.2%)119(29.9%)156(38.0%)52(12.7%)0.03252.30.001
Male17(14.7%)31(26.6%)37(31.9%)31(26.7%)303.2a
ADLF:
Vitamin D deficiency6(13.6%)11(25.0%)21(47.7%)6(13.6%)0.25015.89 ± 3.3840.000
Hypothyroidism7(18.4%)8(21.1%)16(42.1%)7(18.4%)13.79 ± 2.361
Elevated ESR6(15.8%)6(15.8%)16(42.1%)10(26.3%)15.26 ± 2.777
Diabetes3(8.3%)9(25.0%)16(44.4%)8(22.2%)15.81 ± 2.703
Iron deficiency anemia4(16.0%)6(24.0%)10(40.0%)5(20.0%)15.52 ± 3.137b
Concurrent type of alopecia:
Androgenic alopecia23(20%)33(28.7%)39(33.9%)20(17.4%)0.03815.90 ± 3.1150.568
Alopecia areata2(7.1%)10(35.7%)11 (39.3%)5 (17.9%)15.71 ± 3.196
Cicatricial alopecia1(25.0%)2(50.0%)1(25.0%)0(0.0%)13.75 ± 3.304b
Smoking7(12.3%)18(31.6%)19(33.3%)13(22.8%)0.269259.1 vs 264.0a0.816
Addiction3(7.0%)12(27.9%)17(39.5%)11(25.6%)0.089264.9 vs 248.2a0.489
DHLOAI (week) (Mean ± SD)8.89 ± 2.0397.98 ± 1.6937.12 ± 1.3156.81 ± 1.2730.000
MHL (week)9.0(3.0)8.0(2)7.0(2)7.0(2)0.000
Median (IQR)

Table 3

VariablesCoefficientS.EP-value95% CI
COVID-19 Grade I2.7490.8250.001(1.13, 4.36)
COVID-19 Grade II4.7780.8340.000(3.14, 6.41)
COVID-19 Grade III7.5420.8850.000(5.8, 9.27)
Sex0.9040.2160.000(0.48, 1.32)
Age0.1400.0120.000(0.11, 0.16)
Concurrent types of alopecia0.5080.1200.000(0.27, 0.74)
DHLOAI-1.8190.2210.000(-2.25, -1.38)

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