{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:27:34Z","timestamp":1787772454420,"version":"build-2784847793"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Severe Acute Respiratory Virus Corona Virus 2 (SARS-CoV-2) has got its name Corona from Latin meaning \u201ccrown.\u201d It has crown-like spikes present on the surface, which encloses the RNA, genetic material of this deadly virus. The virus attacks pneumocytes after binding with the angiotensin-converting enzyme 2 (ACE2) of the cell surface, which ultimately leads to chemotaxis followed by leukocyte infiltration, increased permeability of blood vessels and alveolar walls, and decreased surfactant in the lung leading to various symptoms. Skin provides a window to the internal changes of the body and also to mechanisms that are not readily visible. Commonly observed skin manifestations include vesicular lesions, maculopapular exanthema, urticarial eruptions, livedo or necrosis, and other forms of vasculitis, chilblain-like lesions. The skin lesions are attributed to either the virus directly affecting the skin or interferon dysregulation due to viral RNA or vascular involvement associated with alteration in coagulation or drug-induced skin manifestations. Observation of skin involvement and the vasculature due to SARS-CoV-2 illustrates the need for a precise stratification and differential diagnostic valuation so that the mechanisms of this novel virus are clearer for better management of the condition in the future. Vascular skin lesions are not seen in all the patients of COVID, but certain lesions should definitely alarm us to evaluate for coagulation abnormalities, complement levels, and skin biopsy, especially in critically ill patients. This review attempts to outline the pathogen briefly and the pathomechanism behind the development of various cutaneous manifestations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijd.ijd_467_21","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T12:20:44Z","timestamp":1716985244000},"page":"231-236","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Virology and Etiopathogenesis of COVID-19 with Special Reference to Cutaneous Implications"],"prefix":"10.4103","volume":"66","author":[{"given":"Rashmi","family":"Sarkar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shashank","family":"Bhargava","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vibhu","family":"Mendiratta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R2-2-20240829","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/S2213-2600(20)30165-X","article-title":"Understanding pathways to death in patients with COVID-19","volume":"8","author":"Vincent","year":"2020","journal-title":"Lancet Respir Med"},{"key":"R3-2-20240829","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/978-1-4939-2438-7_1","article-title":"Coronaviruses: An overview of their replication and pathogenesis","volume":"1282","author":"Fehr","year":"2015","journal-title":"Methods Mol Biol"},{"key":"R4-2-20240829","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1055\/s-0040-1710050","article-title":"Severe COVID-19 during pregnancy and possible vertical transmission","volume":"37","author":"Alzamora","year":"2020","journal-title":"Am J Perinatol"},{"key":"R5-2-20240829","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1080\/22221751.2020.1729071","article-title":"Molecular and serological investigation of 2019-nCoV infected patients: Implication of multiple shedding routes","volume":"9","author":"Zhang","year":"2020","journal-title":"Emerg Microbes Infect"},{"key":"R6-2-20240829","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.jhin.2020.01.022","article-title":"Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents","volume":"104","author":"Kampf","year":"2020","journal-title":"J Hosp Infect"},{"key":"R7-2-20240829","doi-asserted-by":"crossref","first-page":"1583","DOI":"10.3201\/eid2607.200885","article-title":"Aerosol and surface distribution of severe acute respiratory syndrome coronavirus 2 in hospital wards, Wuhan, China, 2020","volume":"26","author":"Guo","year":"2020","journal-title":"Emerg Infect Dis"},{"key":"R8-2-20240829","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1002\/path.1570","article-title":"Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus\u2014A first step in understanding SARS pathogenesis","volume":"203","author":"Hamming","year":"2004","journal-title":"J Pathol"},{"key":"R9-2-20240829","doi-asserted-by":"crossref","first-page":"2605","DOI":"10.1161\/CIRCULATIONAHA.104.510461","article-title":"Effect of angiotensin-converting enzyme inhibition and angiotensin II receptor blockers on cardiac angiotensin-converting enzyme 2","volume":"111","author":"Ferrario","year":"2005","journal-title":"Circulation"},{"key":"R10-2-20240829","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1016\/S0140-6736(20)30917-X","article-title":"COVID-19: The case for health-care worker screening to prevent hospital transmission","volume":"395","author":"Black","year":"2020","journal-title":"Lancet"},{"key":"R11-2-20240829","doi-asserted-by":"crossref","first-page":"56","DOI":"10.4103\/ijp.IJP_115_20","article-title":"Drug targets for corona virus: A systematic review","volume":"52","author":"Prajapat","year":"2020","journal-title":"Indian J Pharmacol"},{"key":"R12-2-20240829","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/bs.aivir.2019.08.002","article-title":"Structural insights into coronavirus entry","volume":"105","author":"Tortorici","year":"2019","journal-title":"Adv Virus Res"},{"key":"R13-2-20240829","first-page":"1","article-title":"Host factors in coronavirus replication","volume":"419","author":"de Wilde","year":"2018","journal-title":"Curr Top Microbiol Immunol"},{"key":"R14-2-20240829","first-page":"31","article-title":"Coronavirus transcription: A perspective","volume":"287","author":"Sawicki","year":"2005","journal-title":"Curr Top Microbiol Immunol"},{"key":"R15-2-20240829","doi-asserted-by":"crossref","first-page":"5288","DOI":"10.1128\/JVI.79.9.5288-5295.2005","article-title":"Identification of novel subgenomic RNAs and noncanonical transcription initiation signals of severe acute respiratory syndrome coronavirus","volume":"79","author":"Hussain","year":"2005","journal-title":"J Virol"},{"key":"R16-2-20240829","doi-asserted-by":"crossref","first-page":"14406","DOI":"10.1074\/jbc.RA119.008964","article-title":"The C-terminal domain of the MERS coronavirus M protein contains a trans-Golgi network localization signal","volume":"294","author":"Perrier","year":"2019","journal-title":"J Biol Chem"},{"key":"R17-2-20240829","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1128\/MMBR.69.4.635-664.2005","article-title":"Coronavirus pathogenesis and the emerging pathogen severe acute respiratory syndrome coronavirus","volume":"69","author":"Weiss","year":"2005","journal-title":"Microbiol Mol Biol Rev"},{"key":"R18-2-20240829","doi-asserted-by":"crossref","first-page":"251","DOI":"10.4103\/ijd.IJD_360_20","article-title":"Coronavirus disease of 2019 (COVID-19) facts and figures: What every dermatologist should know at this hour of need","volume":"65","author":"Manchanda","year":"2020","journal-title":"Indian J Dermatol"},{"key":"R19-2-20240829","doi-asserted-by":"crossref","first-page":"337","DOI":"10.4103\/ijd.IJD_561_20","article-title":"Bio-medical research in COVID-19 times","volume":"65","author":"Sil","year":"2020","journal-title":"Indian J Dermatol"},{"key":"R20-2-20240829","doi-asserted-by":"crossref","first-page":"5","DOI":"10.4103\/Pigmentinternational.Pigmentinternational_35_20","article-title":"Novel corona virus infection: A dermatologist's perspective","volume":"7","author":"Sarkar","year":"2020","journal-title":"Pigment Int"},{"key":"R21-2-20240829","first-page":"e212","article-title":"Cutaneous manifestations in COVID-19: A first perspective","volume":"34","author":"Recalcati","year":"2020","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"R22-2-20240829","first-page":"e246","article-title":"COVID-19 and cutaneous manifestations","volume":"34","author":"Mungmungpuntipantip","year":"2020","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"R23-2-20240829","doi-asserted-by":"crossref","first-page":"e659","DOI":"10.1111\/jdv.16745","article-title":"SARS-CoV-2, skin lesions and the need of a multidisciplinary approach","volume":"34","author":"Cabrera-Hern\u00e1ndez","year":"2020","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"R24-2-20240829","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1111\/bjd.19163","article-title":"Classification of the cutaneous manifestations of COVID-19: A rapid prospective nationwide consensus study in Spain with 375 cases","volume":"183","author":"Galv\u00e1n Casas","year":"2020","journal-title":"Br J Dermatol"},{"key":"R25-2-20240829","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1111\/bjd.19311","article-title":"Sars-CoV-2 infection: The same virus can cause different cutaneous manifestations","volume":"183","author":"Drago","year":"2020","journal-title":"Br J Dermatol"},{"key":"R26-2-20240829","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.clindermatol.2020.12.004","article-title":"Clinicopathologic correlations of COVID-19-related cutaneous manifestations with special emphasis on histopathologic patterns","volume":"39","author":"Rongioletti","year":"2021","journal-title":"Clin Dermatol"},{"key":"R28-2-20240829","doi-asserted-by":"crossref","first-page":"e2130","DOI":"10.1002\/rmv.2130","article-title":"Lessons from dermatology about inflammatory responses in Covid-19","volume":"30","author":"Criado","year":"2020","journal-title":"Rev Med Virol"},{"key":"R29-2-20240829","doi-asserted-by":"crossref","first-page":"e8","DOI":"10.1016\/S0140-6736(20)31526-9","article-title":"An adult with Kawasaki-like multisystem inflammatory syndrome associated with COVID-19","volume":"396","author":"Shaigany","year":"2020","journal-title":"Lancet"},{"key":"R30-2-20240829","first-page":"302","article-title":"Clinical and coagulation characteristics of 7 patients with critical COVID-2019 pneumonia and acro-ischemia","volume":"41","author":"Zhang","year":"2020","journal-title":"Zhonghua Xue Ye Xue Za Zhi"},{"key":"R32-2-20240829","doi-asserted-by":"crossref","first-page":"e38","DOI":"10.1056\/NEJMc2007575","article-title":"Coagulopathy and antiphospholipid antibodies in patients with Covid-19","volume":"382","author":"Zhang","year":"2020","journal-title":"N Engl J Med"},{"key":"R33-2-20240829","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1007\/s11926-008-0073-y","article-title":"Virus-induced vasculitis","volume":"10","author":"Sharlala","year":"2008","journal-title":"Cur Rheumatol Rep"},{"key":"R34-2-20240829","doi-asserted-by":"crossref","first-page":"e46","DOI":"10.1016\/S2213-2600(20)30216-2","article-title":"COVID-19 cytokine storm: The interplay between inflammation and coagulation","volume":"8","author":"Jose","year":"2020","journal-title":"Lancet Raspir Med"},{"key":"R35-2-20240829","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1016\/S0140-6736(20)30566-3","article-title":"Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: A retrospective cohort study","volume":"395","author":"Zhou","year":"2020","journal-title":"Lancet"},{"key":"R36-2-20240829","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1111\/jth.14768","article-title":"Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia","volume":"18","author":"Tang","year":"2020","journal-title":"J Thromb Haemost"},{"key":"R37-2-20240829","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.trsl.2020.04.007","article-title":"Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: A report of five cases","volume":"220","author":"Magro","year":"2020","journal-title":"Transl Res"},{"key":"R38-2-20240829","doi-asserted-by":"crossref","first-page":"e13696","DOI":"10.1111\/dth.13696","article-title":"Cutaneous manifestations of COVID-19: A review of the published literature","volume":"33","author":"Elmas","year":"2020","journal-title":"Dermatol Ther"},{"key":"R39-2-20240829","first-page":"411","article-title":"[A pathological report of three COVID-19 cases by minimally invasive autopsies]","volume":"49","author":"Yao","year":"2020","journal-title":"Zhonghua Bing Li Xue Za Zhi"},{"key":"R40-2-20240829","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1007\/s00415-004-0519-8","article-title":"Large artery ischaemic stroke in severe acute respiratory syndrome (SARS)","volume":"251","author":"Umapathi","year":"2004","journal-title":"J Neurol"},{"key":"R41-2-20240829","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4103\/Pigmentinternational.Pigmentinternational_24_20","article-title":"COVID-19 and the dermatologist: Finding calm in the chaos","volume":"7","author":"Jagadeesan","year":"2020","journal-title":"Pigment Int"},{"key":"R42-2-20240829","doi-asserted-by":"crossref","first-page":"151","DOI":"10.2165\/00128071-200102030-00004","article-title":"Drug-induced urticaria. Recognition and treatment","volume":"2","author":"Shipley","year":"2001","journal-title":"Am J Clin Dermatol"},{"key":"R43-2-20240829","doi-asserted-by":"crossref","first-page":"e561","DOI":"10.1111\/jdv.16709","article-title":"Exanthema and eosinophilia in Covid-19 patients: Has viral infection a role in drug induced exanthemas?","volume":"34","author":"Rosell-D\u00edaz","year":"2020","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"R44-2-20240829","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1007\/s40257-018-00416-4","article-title":"Drug reaction with eosinophilia and systemic symptoms (DRESS): How far have we come?","volume":"20","author":"Mart\u00ednez-Cabriales","year":"2019","journal-title":"Am J Clin Dermatol"},{"key":"R45-2-20240829","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1093\/rheumatology\/kep026","article-title":"Infection and vasculitis","volume":"48","author":"Belizna","year":"2009","journal-title":"Rheumatology (Oxford"}],"container-title":["Indian Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijd.ijd_467_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:47:39Z","timestamp":1787770059000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijd.ijd_467_21"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":42,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/ijd.ijd_467_21","relation":{},"ISSN":["0019-5154"],"issn-type":[{"value":"0019-5154","type":"print"}],"subject":[],"published":{"date-parts":[[2021,5]]}}}