Hair loss after SARS-CoV2 Infection
DOI:
https://doi.org/10.12775/JEHS.2023.13.02.005Keywords
alopecia, COVID 19, hair lossAbstract
Introduction:Since the detection of SARS-CoV-2 in China, more than 3.8 million people have died. A big problem is the long-term effects and complications of this disease. The pathogenesis of these long-term effects is not fully known. Significant increases in pro-inflammatory cytokines have been observed among people with complications. Their dermatological manifestations are due to the presence of receptors for angiotensin-converting enzyme 2 in the skin and other tissues.
Aim of the study: Summary of current knowledge on the pathogenesis, diagnosis, treatment of hair loss after Covid-19.
Methods and materials: A review of the literature available in the PubMed database, using the following terms: “Hair loss after Covid”, “Tellgoen Effluvium covid”, “Alopecia areata covid”, “androgenetic alopecia covid”.
Results: The most commonly reported among the dermatological manifestations is hair loss, the predominant type of which is telogen alopecia, which involves a prolongation of the resting phase of the hair most likely due to an increase in pro-inflammatory cytokines and depletion of anticoagulant proteins, leading to microthrombosis. There has also been a significant increase in the incidence of alopecia areata, in the development of which, in addition to autoimmunity, psychological and physiological stress factors are also highly influential and are higher during the course of the disease including SARS-CoV2. Androgenetic alopecia results from excess androgens and increased sensitivity of hair follicles to them, transmembrane serine protease 2 facilitates the "entry" of the virus into the body by facilitating the binding of viral particles to ACE-2 receptors, which acts as a gateway.
Conclusion: Hair loss is not life-threatening however it has serious psychological and social implications, so it is very important to educate patients about the mechanism and treatment of this phenomenon.
References
Fernández-de-Las-Peñas C, Martín-Guerrero JD, Pellicer-Valero ÓJ, Navarro-Pardo E, Gómez-Mayordomo V, Cuadrado ML, Arias-Navalón JA, Cigarán-Méndez M, Hernández-Barrera V, Arendt-Nielsen L. Female Sex Is a Risk Factor Associated with Long-Term Post-COVID Related-Symptoms but Not with COVID-19 Symptoms: The LONG-COVID-EXP-CM Multicenter Study. J Clin Med. 2022 Jan 14;11(2):413. doi: 10.3390/jcm11020413. PMID: 35054108; PMCID: PMC8778106.
Wenham C, Smith J, Morgan R; Gender and COVID-19 Working Group. COVID-19: the gendered impacts of the outbreak. Lancet. 2020 Mar 14;395(10227):846-848. doi: 10.1016/S0140-6736(20)30526-2. Epub 2020 Mar 6. PMID: 32151325; PMCID: PMC7124625.
Lopez-Leon S, Wegman-Ostrosky T, Perelman C, Sepulveda R, Rebolledo PA, Cuapio A, Villapol S. More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. Sci Rep. 2021 Aug 9;11(1):16144. doi: 10.1038/s41598-021-95565-8. PMID: 34373540; PMCID: PMC8352980.
Aiyegbusi OL, Hughes SE, Turner G, Rivera SC, McMullan C, Chandan JS, Haroon S, Price G, Davies EH, Nirantharakumar K, Sapey E, Calvert MJ; TLC Study Group. Symptoms, complications and management of long COVID: a review. J R Soc Med. 2021 Sep;114(9):428-442. doi: 10.1177/01410768211032850. Epub 2021 Jul 15. PMID: 34265229; PMCID: PMC8450986.
Subramanian A, Nirantharakumar K, Hughes S, Myles P, Williams T, Gokhale KM, Taverner T, Chandan JS, Brown K, Simms-Williams N, Shah AD, Singh M, Kidy F, Okoth K, Hotham R, Bashir N, Cockburn N, Lee SI, Turner GM, Gkoutos GV, Aiyegbusi OL, McMullan C, Denniston AK, Sapey E, Lord JM, Wraith DC, Leggett E, Iles C, Marshall T, Price MJ, Marwaha S, Davies EH, Jackson LJ, Matthews KL, Camaradou J, Calvert M, Haroon S. Symptoms and risk factors for long COVID in non-hospitalized adults. Nat Med. 2022 Aug;28(8):1706-1714. doi: 10.1038/s41591-022-01909-w. Epub 2022 Jul 25. PMID: 35879616; PMCID: PMC9388369.
Almas T, Malik J, Alsubai AK, Jawad Zaidi SM, Iqbal R, Khan K, Ali M, Ishaq U, Alsufyani M, Hadeed S, Alsufyani R, Ahmed R, Thakur T, Huang H, Antony M, Antony I, Bhullar A, Kotait F, Al-Ani L. Post-acute COVID-19 syndrome and its prolonged effects: An updated systematic review. Ann Med Surg (Lond). 2022 Aug;80:103995. doi: 10.1016/j.amsu.2022.103995. Epub 2022 Jun 15. PMID: 35721785; PMCID: PMC9197790.
Merad M, Blish CA, Sallusto F, Iwasaki A. The immunology and immunopathology of COVID-19. Science. 2022 Mar 11;375(6585):1122-1127. doi: 10.1126/science.abm8108. Epub 2022 Mar 10. PMID: 35271343.
Liu J, Li Y, Liu L, Hu X, Wang X, Hu H, Hu Z, Zhou Y, Wang M. Infection of human sweat glands by SARS-CoV-2. Cell Discov. 2020 Nov 13;6(1):84. doi: 10.1038/s41421-020-00229-y. PMID: 33298845; PMCID: PMC7661176.
Choi BY. Hair-Growth Potential of Ginseng and Its Major Metabolites: A Review on Its Molecular Mechanisms. Int J Mol Sci. 2018 Sep 11;19(9):2703. doi: 10.3390/ijms19092703. PMID: 30208587; PMCID: PMC6163201.
Park AM, Khan S, Rawnsley J. Hair Biology: Growth and Pigmentation. Facial Plast Surg Clin North Am. 2018 Nov;26(4):415-424. doi: 10.1016/j.fsc.2018.06.003. Epub 2018 Aug 16. PMID: 30213423.
Seirafianpour F, Sodagar S, Pour Mohammad A, Panahi P, Mozafarpoor S, Almasi S, Goodarzi A. Cutaneous manifestations and considerations in COVID-19 pandemic: A systematic review. Dermatol Ther. 2020 Nov;33(6):e13986. doi: 10.1111/dth.13986. Epub 2020 Aug 6. PMID: 32639077; PMCID: PMC7362033.
Asghar F, Shamim N, Farooque U, Sheikh H, Aqeel R. Telogen Effluvium: A Review of the Literature. Cureus. 2020 May 27;12(5):e8320. doi: 10.7759/cureus.8320. PMID: 32607303; PMCID: PMC7320655.
Otsuka Y, Nakano Y, Hagiya H, Tokumasu K, Otsuka F. Recovery From Alopecia After COVID-19. Cureus. 2022 Jan 12;14(1):e21160. doi: 10.7759/cureus.21160. PMID: 35165610; PMCID: PMC8831424.
Seyfi S, Alijanpour R, Aryanian Z, Ezoji K, Mahmoudi M. Prevalence of telogen effluvium hair loss in COVID-19 patients and its relationship with disease severity. J Med Life. 2022 May;15(5):631-634. doi: 10.25122/jml-2021-0380. PMID: 35815081; PMCID: PMC9262270.
Ohyama M, Matsudo K, Fujita T. Management of hair loss after severe acute respiratory syndrome coronavirus 2 infection: Insight into the pathophysiology with implication for better management. J Dermatol. 2022 Oct;49(10):939-947. doi: 10.1111/1346-8138.16475. Epub 2022 May 27. PMID: 35633047; PMCID: PMC9348110.
Czech T, Sugihara S, Nishimura Y. Characteristics of hair loss after COVID-19: A systematic scoping review. J Cosmet Dermatol. 2022 Sep;21(9):3655-3662. doi: 10.1111/jocd.15218. Epub 2022 Jul 19. PMID: 35801366; PMCID: PMC9349634.
Aryanian Z, Balighi K, Hatami P, Afshar ZM, Mohandesi NA. The role of SARS-CoV-2 infection and its vaccines in various types of hair loss. Dermatol Ther. 2022 Jun;35(6):e15433. doi: 10.1111/dth.15433. Epub 2022 Apr 1. PMID: 35266262; PMCID: PMC9111640.
Christensen RE, Jafferany M. Association between alopecia areata and COVID-19: A systematic review. JAAD Int. 2022 Jun;7:57-61. doi: 10.1016/j.jdin.2022.02.002. Epub 2022 Feb 10. PMID: 35165668; PMCID: PMC8828419.
FIvenson D. COVID-19: association with rapidly progressive forms of alopecia areata. Int J Dermatol. 2021 Jan;60(1):127. doi: 10.1111/ijd.15317. Epub 2020 Nov 23. PMID: 33226118; PMCID: PMC7753616.
Moradi F, Enjezab B, Ghadiri-Anari A. The role of androgens in COVID-19. Diabetes Metab Syndr. 2020 Nov-Dec;14(6):2003-2006. doi: 10.1016/j.dsx.2020.10.014. Epub 2020 Oct 15. PMID: 33091758; PMCID: PMC7557269.
Moravvej H, Pourani MR, Baghani M, Abdollahimajd F. Androgenetic alopecia and COVID-19: A review of the hypothetical role of androgens. Dermatol Ther. 2021 Jul;34(4):e15004. doi: 10.1111/dth.15004. Epub 2021 Jun 9. PMID: 34033224; PMCID: PMC8209856.
Chen S, Xie X, Zhang G, Zhang Y. Comorbidities in Androgenetic Alopecia: A Comprehensive Review. Dermatol Ther (Heidelb). 2022 Oct;12(10):2233-2247. doi: 10.1007/s13555-022-00799-7. Epub 2022 Sep 17. PMID: 36115913; PMCID: PMC9483356.
Wambier CG, Vaño-Galván S, McCoy J, Gomez-Zubiaur A, Herrera S, Hermosa-Gelbard Á, Moreno-Arrones OM, Jiménez-Gómez N, González-Cantero A, Fonda-Pascual P, Segurado-Miravalles G, Shapiro J, Pérez-García B, Goren A. Androgenetic alopecia present in the majority of patients hospitalized with COVID-19: The "Gabrin sign". J Am Acad Dermatol. 2020 Aug;83(2):680-682. doi: 10.1016/j.jaad.2020.05.079. Epub 2020 May 22. PMID: 32446821; PMCID: PMC7242206.
Trüeb RM, van Neste D, Gavazzoni Dias MFR, Kopera D, Lee WS, Ioannides D, Rezende HD, Fellas AR, Uribe NC. Comment on: The Gabrin sign. J Am Acad Dermatol. 2021 Mar;84(3):e147-e148. doi: 10.1016/j.jaad.2020.11.046. Epub 2020 Nov 27. PMID: 33253850; PMCID: PMC7832436.
Nalluri R, Harries M. Alopecia in general medicine. Clin Med (Lond). 2016 Feb;16(1):74-8. doi: 10.7861/clinmedicine.16-1-74. PMID: 26833522; PMCID: PMC4954340.
Sattur SS, Sattur IS. COVID-19 Infection: Impact on Hair. Indian J Plast Surg. 2021 Dec 13;54(4):521-526. doi: 10.1055/s-0041-1740289. PMID: 34984095; PMCID: PMC8719952.
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