Post COVID Telogen Effluvium: Another Study Highlights the Features

Post COVID Telogen Effluvium Affects Women to Greater Extents than Men

A new study adds to the growing body of published medical literature showing that telogen effluvium occurs in a significant proportion of patients after COVID 19 and is more likely to affect women than men.

Monari et al, 2022

Researchers from Italy conducted a hospital-based, cross-sectional study of patients who were discharged with a diagnosis of SARS-CoV-2 pneumonia during the early days of the pandemic ( 1 March to 4 April 2020).

There were ninety-six patients were consecutively enrolled in the study. The mean age of the patients was 59.0 years. 64.6 % were males and 35.4 % were females. There with no significant difference in mean age. Patients were hospitalized for an average of 13 days. The mean duration of fever was 11.0 days (9.0–13.0). Patients received a variety of treatments during their hospital stay including hydroxychloroquine, 24 (25%) steroids, 59 (61.5%) azithromycin, 31 (32.3%) anticoagulants or antiplatelet agents for pulmonary embolism prophylaxis, and 73 (76%) required oxygen therapy. Ritonavir was the most used antiviral drug (94 patients, 97.9%), followed by darunavir, administered to 84 patients (87.5%), while lopinavir was given to 24 patients (25%).

Hair loss occurred in 30 of the 96 patients (31.3%). 22 (73.3%) were females and 8 (26.7%) males, with a significant difference in gender. The average time elapsed from the onset of the first symptom (fever) to that of hair loss was 68.43 days, with a difference between females (72 days) and males (54 days). Eight patients (26.6%) reported trichodynia as the initial symptom of telogen effluvium. There was no association between COVID-19-related characteristics (days of hospitalization, days with fever, type of therapy) and telogen effluvium.

Conclusion

This is an interesting study which confirms some of what we have come to understand so far in the pandemic. Hair shedding or telogen effluvium occurs about 8-10 weeks after COVID 19 infection and affects 30-50 % of patients. Women are consistently more likely to have shedding than are men. Disease severity has been linked to an increased chance of shedding is some but not all studies. What has become increasingly clear in these studies is the consist link between trichodynia and post COVID TE. There is a scalp pain and burning that is clearly part of the post covid shedding syndrome. Muller et al also recently showed that about 25 % of patients have trichodynia. In this study, the authors highlight that trichodynia occurs in about one quarter of patients and can be an initial symptom.

REFERENCE

Monari et al. Post-SARS-CoV-2 Acute Telogen Effluvium: An Expected Complication. J Clin Med. 2022 Feb 24;11(5):1234.