It was confirmed that COVID-19 infection is accompanied by a reduction in lymphocytes, monocytes, and eosinophils, along with a significant reduction of CD4/CD8 T cells, B cells, and natural killer (NK) cells. It was further revealed that non-survivor COVID-19 patients continued to show a decrease in lymphocyte count along the course of their disease until death.12-15
Diminished levels of natural killer (NK) cells and B-cells activity in the lesions of PR have been observed.16 This suggests the role of a T-cell mediated immunity. Besides, increased amounts of CD4 T cells and Langerhans cells have been found in the dermis, which possibly points towards viral antigen processing and presentation. However, this matter is still debated since some individuals are infected with HHV 6–7 and do not develop the disease.17
New information and cutaneous manifestations possibly related to COVID-19 are emerging every day. Further studies are needed to evaluate whether these lesions are associated with the virus or not. Careful documentation and robust reporting of cutaneous manifestations associated with COVID-19 are needed to augment our understanding of disease presentation and epidemiology.
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