Dear Editor,It is recognized that the majority of the infections with COVID‐19 presented with mild and moderate symptoms, however, the minority (15%) of the infections can progress to severe pneumonia and acute respiratory distress syndrome (ARDS), or can progress to multiple organ failure.
Morbilliform rashes, chicken‐pox like lesions, covid toe and a various lesions were the main skin manifestations reported during COVID 19 epidemics.
There are recent reports on cases of herpes zoster infections among a symptomatic COVID‐19 infection.
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Therefore, identifying or to raise the suspicion of the asymptomatic carriers is of paramount in the management of COVID‐19 outbreak.The plausible explanation for the herpes zoster infections among a symptomatic COVID‐19 infections is the lymphopenia (which can favor herpes virus recurrences) which is a result of infecting lymphocytes and activation‐induced cell death and impairment to antiviral responses.
Therefore, the point of herpes zoster infections among a symptomatic COVID‐19 infection should be put in mind when a broad immunosuppression is used in patients with severe viral illness and the pros and cons of anti‐inflammatory effects vs the delay of virus clearance.