Skin doctors suddenly are looking at a lot of toes — whether by emailed picture or video visit — as concern grows that for some people, a sign of COVID-19 may pop up in an unusual spot.
Boston dermatologist Esther Freeman expected to see skin complaints as the pandemic unfolded — various kinds of rashes occur when people get very ill from other viruses.
“But I was not anticipating those would be toes,” said Freeman of Massachusetts General Hospital, who has viewed via telemedicine more toes in the last several weeks than in her entire career.
They’re being called “COVID toes,” red, sore and sometimes itchy swellings on toes that look like chilblains, something doctors normally see on the feet and hands of people who’ve spent a long time outdoors in the cold.
Don’t race to the emergency room if toes are the only worry, said the American Academy of Dermatology.
Earlier this month, it issued advice that a telemedicine check is the first step for people wondering if they have “COVID toes” and who have no other reason for urgent care. Doctors then should decide if the patient should stay in home isolation or get tested.
The most common coronavirus symptoms are fever, a dry cough and shortness of breath -- and some people are contagious despite never experiencing symptoms. But as this bewildering virus continues to spread, less common symptoms are being reported including loss of smell, vomiting and diarrhea, and increasingly, a variety of skin problems.
In one report, dermatologists evaluated 88 COVID-19 patients in an Italian hospital and found 1 in 5 had some sort of skin symptom, mostly red rashes over the trunk. In another, Spanish doctors reported a series of 375 confirmed virus patients with a range of skin complaints, from hives to chickenpox-like lesions to the toe swellings.
Pictures of reddened toes and rashes all over social media and doctor chat groups have “already enabled the rapid recognition of skin signs by dermatologists. It is now time for rigorous science” to understand the link, Dr. Kanade Shinkai of the University of California, San Francisco wrote in a recent JAMA Dermatology editorial.
Boston’s Freeman directs an international COVID-19 registry for doctors to report cases of possibly virus-linked skin symptoms. Of 500 reports since late March, about half are chilblain-like spots on the feet, she said.
Chilblains, what doctors call “pernio,” are an inflammatory reaction. When pernio-like reactions appear in coronavirus-infected patients is one of many mysteries. For some people, it’s the first or even only symptom they notice. Others see the toe problem at the same time or even a few weeks after experiencing more common and serious COVID-19 symptoms.
It’s showing up in young people too, according to Dr. Amy Paller of Northwestern University, who is part of a pediatric dermatology registry also collecting images of patients’ toes.
Among the theories: Is it just inflammation triggered by an infection instead of the cold? Is the virus irritating the lining of blood vessels in the skin, or perhaps causing microscopic blood clots?
“The public health message is not to panic,” Freeman said, noting that most toe patients she’s seen haven’t become severely ill.
Are they contagious? “We can’t tell just by looking at your toes,” she said. Other medical conditions, such as lupus, can cause similar spots — another reason doctors should discuss each patient’s overall health and next steps for testing or other needed care.
Are you experiencing chronic anxiety over the risk of getting infected by the life-threatening COVID19 disease or impending financial hardship? Besides sucking the mental strength, anxiety may weaken your immune system. Doing mind and body practices through Yoga, you can build strong immunity besides keeping your mind calm. Yoga inherits a 5,000-year history combining diversified methods of meditation, breathing techniques, and physical postures. Adding Yoga in your daily routine can strengthen your mind and body to overcome the Coronavirus challenge. Read this article to know about some free online Yoga courses which you can attain during the quarantine.
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People who tend to sit down for long hours due to office duty or study purpose, often complain about chronic pain in the eyes, neck, shoulder, back, and various other parts of the body. Though medications can provide temporal reliefs, aches often tend to come back. You can try some Yoga methods to get relief from these pains. Here comes an online Yoga course for desk workers and Students.
Watching these video classes you can learn how to stretch out and release tension during short work-breaks. This course can teach you specific Yoga techniques to increase circulations of different body-parts to heal the pain. Besides decreasing stress and anxiety, these Yoga methods will improve your posture, strengthen spine health, and increase your overall level of productivity at work or study. Click the following link to join this course: https://www.udemy.com/course/deskyoga/
You May Also Like: Where to Find Online Courses during Coronavirus Home Quarantine.
Are you a busy mom or a hectic professional for whom spending one hour on Yoga every day is more than a daydream? Don’t worry! You can practice Yoga even if you can manage only 10 minutes from your tight schedule. Here comes a 10 Minute Yoga Course to get a healthy mind, body, and spirit!
These video classes will teach you three sequences. The ‘Dream’ sequence will help you in setting your intention and warming up the body to start an amazing day. Then the ‘Feel Free’ sequence will teach you some postures of stretching, twisting, and standing poses which can make you feel relaxed. The last ‘Heart Open’ sequence will show you some forward and backward bends enabling you to love wholeheartedly. Besides, relaxing your body, this Yoga course will improve your focus, mental strength, and confidence every single day. Click the following link to participate in this course: https://www.udemy.com/course/10-minute-yoga-happy-mind-body-spirit-in-just-10-mins/
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Yin yoga can activate your parasympathetic nervous system which controls the rest and digest mode of your body. These Yoga methods will help you in developing patience and ways of acceptance. You will gain the ability to observe thoughts, and control reactions. All of these actions can calm your nervous system to release tensions, which would help you in getting better sleep every night. Click the link below to join this course: https://www.udemy.com/course/yin-yoga-for-sleep/
Do you have a passion for traditional meditation practice? You can try this course to learn Kundalini Yoga based on Chakras knowledge. The term ‘Chakras’ refers to different focal points of the body that are applied for meditation practices. This concept was generated from the ancient traditions of Hinduism. This course has been designed with eight classes of Chakra balancing exercises.
Watching these video classes you can learn about diverse ancient concepts of energy centers, including their locations, qualities, symbolism, and impact on everyday life. Each exercise usually lasts from 5 to 8 minutes. Overall, these Kundalini Yoga methods will help you in achieving desired outcomes in life and manage your wellbeing in an organized way. Click the following link to join this course: https://www.udemy.com/course/exploring-the-chakras/
Are you tired of suffering from chronic sneezing due to allergic rhinitis/ hayfever? You may know that Allergic rhinitis or hayfever is quite tiresome for the body, mind, and work spirit. Chronic sneezing can lead to blocked sinuses, itchy nose, and sore throat. These symptoms make it difficult for your breathing system to function normally.
Not to mention, during Coronavirus pandemic an incidence of chronic sneezing can make you feel uncomfortable in public. In this section, we are going to present a special course of Yogic Principals and Practices that can release your stress, strengthen your immune system, teach some effective breathing techniques, and finally help you to get rid of the allergic rhinitis/ hayfever. Click the following link to enroll this course: https://www.udemy.com/course/yoga-for-allergic-rhinitis-hayfever/
So far we have discussed several free online Yoga courses worth participating in your quarantine to release stress and build a healthy body. However, it is recommended to keep about two to three hours break between your last meal and Yoga session. Try to apply Yoga Mat and other recommended props to assure your safety while practicing different Yoga Postures. And don’t forget to consult your doctor before doing Yoga, if you have any serious illness.
Many respiratory viruses run rampant in colder months and wane in summer, including influenza and SARS. But will the spread of COVID-19 follow a similar seasonal pattern?
Experts have not found enough scientific evidence that heat and humidity will slow down the virus.
"The COVID-19 virus can be transmitted in all areas, including areas with hot and humid weather," the World Health Organization pointed out in a recent report, indicating that high temperatures have not managed to curb the virus' spread.
As Tom Kotsimbos, associate professor at Australia's Monash University and respiratory physician at the Alfred Hospital in Melbourne, told the Guardian, as this is a new virus, it "does not mean it will be like the others."
"It's interesting that (COVID-19) has spread all over the world quite quickly -- both north and south," he said, adding that the phenomenon suggests either the transmission of the new virus does not rely on temperature or that dependency is not important for its spread.
Though researchers are trying to dig out the relationship between the spread of COVID-19 and temperature, some have already drawn contradictory conclusions.
According to an article published April 2 on the medical journal The Lancet, researchers from the Public Health School of Hong Kong University found an inverse correlation between the temperature and the stability of the virus.
The virus is highly stable at 4 degrees Celsius and could be incubated for up to 14 days; with the incubation temperature increased to 70 degrees Celsius, the time for virus inactivation was reduced to 5 minutes, the researchers said.
By contrast, an article published April 8 on the European Respiratory journal said that researchers from China's Fudan University had found little association of COVID-19 transmission with temperature or UV radiation in Chinese cities.
By analyzing the cumulative number of cases in 224 cities with no fewer than 10 cases as of March 9, the basic reproduction number for 62 cities with over 50 cases as of Feb. 10, and meteorological data such as temperature, humidity, and UV radiation, the scientists concluded that "ambient temperature has no significant impact on the transmission ability of SARS-CoV-2."
"This is quite similar with MERS epidemic in the Arabian Peninsula where MERS cases continue when temperature are 45 degrees Celsius," they said.
Zhu Yifang, associate professor of environmental health sciences at the University of California, Los Angeles, told Xinhua that as related data in the studies are limited, it is uncertain whether the results can be globally verified.
Meanwhile, the possibility cannot be ruled out that the coming hot spells in the Northern Hemisphere might reduce the virus, Zhu said, adding that it also remains unknown whether the pandemic will stage a comeback during winter, becoming seasonal.
For those who often feel anxious and stressed during long sea voyages, probiotics may provide a solution.
Chinese researchers have found that probiotics can ease sailors' pressure and anxiety by improving their intestinal health, according to a recent research article published in the journal Gut Microbes.
Sailors' immunity can decline when they remain in an environment marked by high salinity and strong ultraviolet radiation, said professor Zhang Heping from the Inner Mongolia Agricultural University. Thus their physiological and psychological health will likely be threatened.
The microbial community of the human gut is the foundation for a normal immune system.
The researchers from the university studied the effects of probiotics on the regulation of sailors' intestinal flora and disclosed the possible mechanism of making them more adaptive to the offshore environment.
Compared with the placebo control group, the probiotic group showed a balanced intestinal microbiome, according to the research article.
The research is expected to provide a feasible approach for protecting gut health during long sea voyages.
Covid-19 patients who are getting an experimental drug called remdesivir have been recovering quickly, with most going home in days, STAT News reported Thursday after it obtained a video of a conversation about the trial, reports CNN.
The patients taking part in a clinical trial of the drug have all had severe respiratory symptoms and fever, but were able to leave the hospital after less than a week of treatment, STAT quoted the doctor leading the trial as saying.
"The best news is that most of our patients have already been discharged, which is great. We've only had two patients perish," Dr. Kathleen Mullane, an infectious disease specialist at the University of Chicago who is leading the clinical trial, said in the video.
Mullane did not immediately respond to a request for comment from CNN.
The University of Chicago said Mullane's comments constituted partial information.
"Partial data from an ongoing clinical trial is by definition incomplete and should never be used to draw conclusions about the safety or efficacy of a potential treatment that is under investigation," it said in a statement.
"In this case, information from an internal forum for research colleagues concerning work in progress was released without authorization. Drawing any conclusions at this point is premature and scientifically unsound."
There is no approved therapy for the Covid-19, which can cause severe pneumonia and acute respiratory distress syndrome in some patients. But the National Institutes of Health is organizing trials of several drugs and other treatments, among them remdesivir.
The drug, made by Gilead Sciences, was tested against Ebola with little success, but multiple studies in animals showed the drug could both prevent and treat coronaviruses related to Covid-19, including SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome).
Back in February, the World Health Organization said remdesivir showed potential against Covid-19.
STAT said it obtained and viewed a copy of the video discussion Mullane had last week with colleagues about the trial.
"Most of our patients are severe and most of them are leaving at six days, so that tells us duration of therapy doesn't have to be 10 days," she was quoted as saying.
However, the trial does not include what's known as a control group, so it will be difficult to say whether the drug is truly helping patients recover better. With a control arm, some patients do not receive the drug being tested so that doctors can determine whether it's the drug that is really affecting their condition.
Trials of the drug are ongoing at dozens of other clinical centers, as well. Gilead is sponsoring tests of the drug in 2,400 patients with severe Covid-19 symptoms in 152 trial sites around the world. It's also testing the drug in 1,600 patients with moderate symptoms at 169 hospitals and clinics around the world.
Gilead said it expected results from the trial by the end of the month.
"We understand the urgent need for a COVID-19 treatment and the resulting interest in data on our investigational antiviral drug remdesivir," the company said in a statement to CNN. But it said a few stories about patients are just that -- stories.
"The totality of the data need to be analyzed in order to draw any conclusions from the trial. Anecdotal reports, while encouraging, do not provide the statistical power necessary to determine the safety and efficacy profile of remdesivir as a treatment for Covid-19," Gilead said.