Journal of Family Medicine and Primary Care (Jan 2023)

Association between COVID-19 infection and herpes zoster: A case series

  • Murali Narasimhan,
  • Ramachandran Ramakrishnan,
  • Priya Cinna T. Durai,
  • Boggarapu Sneha

DOI
https://doi.org/10.4103/jfmpc.jfmpc_2112_22
Journal volume & issue
Vol. 12, no. 10
pp. 2516 – 2519

Abstract

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Herpes zoster (HZ) is a manifestation of the reactivation of latent varicella zoster virus (VZV) infection in the dorsal root ganglion. The occurrence of HZ has been reported in association with COVID-19. Herein, we describe 10 cases who developed classic HZ within 2–3 weeks of acquiring COVID-19 infection. The triggers in these patients could be severe stress (related to quarantine issues, fear of hospitalisation and death) immune dysregulation and systemic steroid therapy in treating COVID-19. The clinical patterns and therapeutic responses observed were similar to HZ in immunocompetent persons. Increased expression of NKG2A on NK and CD8+ T cells has been proposed as a pathophysiologic mechanism in triggering HZ at the molecular level in COVID-19 patients. Primary physicians should be aware of this association to counsel and treat such patients appropriately, as initiating early treatment could minimise the risk of complications like postherpetic neuralgia.

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